How can I help my melasma mustache without lasers, getting off birth control and staying out of the sun.

I have the skin condition called melasma. I only have a few spots on my upper lip but it is causing it to look like a mustache. I have tried hydroquinone cream and tri luma. They both have failed. I am not able to get off birth control and I love being in the sun during the summer so that advice will not be helpful for me. I wear 50 sunscreen everyday and I reapply at least every 2 hours. Are there any other suggestions for me?

Doctor Answers 3

Melasma solutions are possible- read more.

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 70 reviews

Addressing melasma

Thank you for your question Norbert. Melasma is a common condition characterized by the appearance of dark patches commonly found on the forehead, cheeks, and upper lip. Melasma is caused by an internal imbalance of hormones which makes the skin more sensitive to the sun. So protection with sunscreen daily is essential. Products such as containing hydroquinone work well for melasma and work best when combined with other products. Sometimes higher strengths of hydroquinone are required; these can be compounded. Sometimes patients need to use the products for at least three months to start seeing improvement. In our office, we use the A E Skin Ultimate Rejuvenation treatment, a treatment I designed that works well for melasma. It starts with a Forever Young BBL IPL photofacial treatment, followed by a Micro Laser Peel and a Pro Fractional Therapy treatment. Immediately afterwards topical liquid hydroquinone is applied. The channels formed in the Pro Fractional step provide access for the hydroquinone to the deeper layers of the skin. Amazing results can be seen. Unfortunately, however, melasma is a condition we control, not cure. So maintenance treatments are required. Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

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. 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
4.9 out of 5 stars 188 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.