I have melasma after having four kids. It's getting worse. I have dark skin tone. And unsure what kind of treatment I should do.

Doctor Answers 8

Melarase creams for pigmentation 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


Dr. Karamanoukian

Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Melasma Treatments

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I usually put my patients on a product we carry called So Bright. This product has skin toning and lightening benefits and combines Kojic Acid, Arbutin and Bearberry, Green Tea and Hydroquinone. I start my patients at either 4% or 6% depending on their skin type. It's a very effective treatment for Melasma. In more severe cases, I will follow up one month later with a series of photofacials. Once the Melasma is under control it is very important to use a sunscreen no less than 50 SPF.

Daniel S. Tresley, MD
Northbrook Oculoplastic Surgeon

Multiple approach to MELASMA

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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.

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help.

More information on available treatments in the Web ref below- VIDEO 
All the best,

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

Treating melasma in darker skin types

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There are many ways to treat melasma. First, important to identify any triggers such as a medication (e.g. birth control pill). Next, starting with a high-quality SPF 60 or higher sunscreen, big hat and sunglasses & sun avoidance is important in preventing worsening. For treatment, see your dermatologist. Starting with creams that contain such ingredients as hydroquinone, retinol, vitamin C, or others that may be mixed together can be quite useful There are also treatments such as chemical peels that can be beneficial. Lasers in dark skin are a last resort.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Melasma for Dark Skin

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Cosmelan is by far the best treatment for Melasma in my patients, particularly in those with dark skin.  It takes two peels combined with the Cosmelan products and I have had amazing results.  Best, Dr. Green

Melasma treatment for dark skin

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The best way to start with dark skin is using skin lightener such as hydroquinone to lighten the melisma. You have to be patient as it does take time. One good skin lightener that is very effective is Obagi Neuderm that contains 4% hydroquinone and over time it will lighten the melisma.  It is also very important that you wear sunscreen with SPF 30++, preferable 50++ daily.
If you are seeking in-office treatments such as laser treatments be sure to consult with a reputable doctor who has experience with darker skin.  Most times darker skin patients worsen from laser treatments. Experienced doctor is the key here.

David P. Melamed, MD
Los Angeles Dermatologist

Tratment of Melasma

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A great option for you would be the Permea laser by Solta. Its 1927nm wavelength makes it very safe on Melasma, and is great for all skin types! I recommend doing a series of at least 4 treatments spaced 4 weeks apart.

#melasma #clearandbrilliant #permea

Melasma treatments

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A great treatment for you would be the Permea laser by Solta. It is a 1927nm wavelength which is very safe on Melasma, and all skin types! I recommend doing a series of at least 4 spaced 4 weeks apart. 

#melasma   #clearandbrilliant   #permea

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

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.