There is no best treatment but mainstay is avoidance of sun exposure, sun block and use of topicals like Melarase and laser. We use Clear + Brilliant.
H Karamanoukian MD FACS
We continue to see very positive results with Melarase creams. I would use a combination of Melarase AM, Melarase PM, Melapads, and Replenish creams.
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. Lately I have also been using the Clear and Brilliant system.
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 Reference below. All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia
Melasma is a problem of the melanocytes, the pigment cells of the skin, usually caused by hormone fluxes or some other internal problem, though pure sun damage can be the cause. If possible, the cause should be eliminated. After that, the best treatment , by far, is the Obagi Nu-Derm system. This is a prescriptive system so you will need to see a doctor specializing in skin rejuvenation who also uses Obagi. (See plasticsurgerytoday.com/beautifulskinlaserresurfacinghighlandsnorthcarolina/obagi-nu-derm/)