Hysterectomy or Oophorectomy to Improve Melasma in 40 y/o?

Question

I have melasma banding on my cheeks underneath the rim of my sunglasses, it basically looks like I have a mask from the cheekbones down. Hats & sunglasses keep everything above the eyes pale. I had 1 Fraxel 2 months ago. The melasma is back despite religiously using pigmentation serum, Vitamin A,B&C serums from AspectDr, Actinica sunscreen, wearing hats & sunglasses even whilst driving, and generally avoiding the sun at all costs. Would removal of the ovaries etc help at all? At wits end.

Harold J. Kaplan, MD · Answer

Hi alt.  We agree with Dr. Luck that we do not feel that surgery is a good option to address your issues.  We also do not feel that Fraxel laser treatments are the best options.

	So often, we hear our patients say that the only hydroquinone bleaching programs they have tried stopped at 4 %.  This is true of most standardized prescription hydorquinone products, but if you search a bit harder you will find practices like ours that focus on higher % hydroquinone treatment programs for patients exactly like yourself.  Our programs vary between 6% and 8% and have a much higher response rate than the traditional 4%.  We use Cosmelan MD and our own product that was formulated with a pharmaceutical firm.  Hope this helps.  Good luck.

T. Wayne Day, MD · Answer

From your description, it sounds as if you are experiencing sunscreen failure. I know you have used an expensive sunscreen, but advertisements that it lasts all day are misleading and probably false.

	I suggest you use a sunscreen like Blue Lizard that is zinc oxide or titanium oxide based.

	The chemical based ones often break down when exposed to sunlight. Also, seek the shade when you are out.

Edward Lack, MD (retired) · Answer

Surgical treatment of melasma is usually ineffective. This is especially true of hysterectomy, oophorectomy, and laser therapy. The best treatment is topical plus light chemical peels.

Hysterectomy or Oophorectomy to Improve Melasma in 40 y/o?

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Hysterectomy or Oophorectomy to Improve Melasma in 40 y/o?

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