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 3

Melasma and IPL- do not do it

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


Brisbane Dermatologist
4.7 out of 5 stars 61 reviews

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

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
4.9 out of 5 stars 165 reviews

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

 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
5.0 out of 5 stars 3 reviews

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