What is the best SPF 100 or SPF 100+ facial suncreen for Melasma? Chemical sunscreens? Physical only suncreens?

A sunscreen with a minimum of SPF 50 and with a physical blocker like Zinc Oxide and Titanium Dioxide is highly recommended for Melasma.

Dark pigmentation on the skin can be due to melasma, age spots, and sun damage. Melasma is a specific hormonally-influenced skin condition in which pigmentation is deposited by overactive pigment cells in your skin.

In our office, we individualize treatments for melasma and skin discoloration based on skin type, skin complexion, hormonal influences, and ethnicity.

Treatments for melasma begin with Melarase creams as follows:

MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Additional therapies include fractional laser, fractional RF, Covalent peels, and LED microneedling with Replenish serum. The video demonstrates the clear and brilliant laser that is used alongside Melarase creams.

Best, 

Dr. Karamanoukian

Realself100 Surgeon

The Picosure laser is the best laser for Melasma and hyperpigmentation. It fires 1,000 faster than any other laser. There is little to no downtime. Use a good sunblock between sessions. Stop any active agents 3 days before your session. Plan at least 3 sessions, with the Picosure laser, each spaced a month apart.david berman md

Sunscreens play a small but vital role in melasma management, if you are after a low irritant but high SPF sunscreen, look for Ti Dioxide or Zn Oxide. Apply 2-3 times a day, adjunctive hats, UV avoidance etc... are all essential. 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