What is the best topical treatment for melasma, and skin color/tone?

I have had melasma and discoloration for years. It comes and goes with summer. I also deal with hormonal acne on occasion. I have been using Cerave products and love them but want to become more aggressive with out doing any lasers. I had decent not great results from triluma in the past. What are your thoughts on tri luma and obagi? Is an obagi system really worth my money and can sensitive skin handle it? Also, what is the cost? Or, is triluma just as effective? Thanks.

Doctor Answers 2

Multiple methods to treat melasma pigmentation.

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. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams.

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia 


Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

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

There is no "cure" for melasma but there are great treatments. We are doing a clinical trial now on clear + brilliant with bleaching and microneedling and getting amazing results. I suggest you see an expert. A combination approach is best as topical products will not yield optimal results alone. You will need lifelong treatment, sun protection, skin care. But these treatments can give you improvement and then you maintain. Best , Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 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.