What treatment would you suggest for my melasma (self diagnosis) on my cheeks, upper lip and nose? Laser? Peel? (Photos)

I've read mixed reviews for IPL and peels especially for people of color. I absolutely do not want to make this worse. I have ordered Reverse by R&F in an effort to lighten at least the large area on my lip and the dark spots that are now ever present on my nose and cheeks. I'm at a loss at this point. I welcome any help you can provide. Thank you.

Doctor Answers 5

Melasma and IPL- do not do it

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Melasma can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I usually start my patients on laser (low dose Q switch or Picosure) a few weeks after they commence on creams. What ever you do, DO NOT try IPL for this condition, especially in your skin type. There is a very high chance of melasma worsening after IPL. Gentle lasers at low power are the best treatments. 

In some cases I combine glycolic AHA peels, or lately low strength TCA Peels, and in other cases I use a tablet called Tranexamic acid to help.

I suggest you consult an expert in melasma management in Atlanta, 

All the best,

Dr Davin Lim
Laser, surgical and aesthetic dermatologist
Brisbane, Australia

Melasma and Sun Spots -- Best Treamtent Is Clear + Brilliant / Fraxel 1927 with Microneedling PRP, Pro Yellow is Useful

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there are many options for improvement but very little for a cure. I suggest you see an expert for treatment options including lasers, skin care and microneedling.  Sunscreen is essential. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

What treatment would you suggest for my melasma (self diagnosis) on my cheeks, upper lip and nose? Laser? Peel?

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 Melasma is an inflammatory process that is chronic. It is caused by too much sun exposure, family history, and hormonal fluctuations including possibly being on birth control pills. I recommend that you limit your soy and your dairy. You must use sun block everyday rain or shine January through December regardless of your ethnicity. I use chemical peels, Fraxel laser and Cosmeceutical to treat-- It really depends on my evaluation. I wish you the best luck. Dr. Downie.

Jeanine B. Downie, MD
Montclair Dermatologic Surgeon

Melarase creams for melasma on the face

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Thank you for your question.  Skin discoloration is a very prevalent problem in women over the age of twenty.  It is also increasingly common in men with increased sun exposure.  

Risk factors include thyroid disease, sun exposure, hormones, pregnancy, family history, PIH, and birth control. Melarase AM and Melarase PM have been extremely effective in reducing pigmentation associated with skin discoloration and hyperstimulation of melanocytes. 

In my practice, patients with hyperpigmentation benefit from twice daily application of the creams. Melarase AM in the morning, followed by Melarase PM in the evening. Melarase AM contains four active sunblocks, so sunscreen is not needed unless your sun exposure is very high or you had a recent procedure/laser. SPF of 30. Melarase PM contains active skin lighteners to even out skin pigmentation. If you are concerned about the development of pigmentation, contact our office to discuss details and to obtain a regimen for Melarase. 

Recommendations:  5-step Daily Brightening Kit has everything you need to improve dark spots, skin discoloration, melasma, and hyperpigmentation caused by sun exposure, hormones, scarring, and the environment. It’s a powerful daily brightening kit that can help bring out your skin’s natural, healthy glow. Ideal for use on the face, neck, and hands. 

Includes: Melaclenz, Melapads, Melarase AM, Melarase PM, Elevase, and Spectrase

Best, 

Dr. Karamanoukian

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

IPl for melasma is not recommended

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IPL can exacerbate melasma.

Melasma needs long term commitment with skin care and avoidance of skin factors such as sun exposure (Spectrase Sun Block) which has wide UV spectrum and SPF 30+ protection. 

Daily good habits with topicals may well help you chieve your goals with a good skin system like the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 

Melarase AM is non hydroquinone based. 

Clear + Brilliant laser can be added once you start your pretreatment with topicals. 

Best

H Karamanoukian MD FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.