Why won't my melasma lighten up at all? (Photos)

I am currently being treated by the top dermatologist in Utah & he has done several laser treatments along with creams, facial treatments and nothing has worked. I have Hispanic ethnicity and have heard that its harder to treat. I am looking online to see what others have done. I have not tried skinbright & wanted to know your thoughts on it.I also use spf 50 by skinmedica.I feel like my Dr. has even given up on me. Any kind of help would be so appreciated. Thanks, Roberta

Doctor Answers 4

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

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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.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Clear and Brilliant laser and Kare skin Brightening kit for melasma

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For difficult melasma such as yours, we would recommend the Kare skin Brightening Kit, light chemical peels, and Clear and Brilliant laser. 


Dr. Karamanoukian

Los Angeles


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Thank you for your question. There is no cure for melasma. I would recommend seeking a consultation with another provider if you feel  you are not receiving the best service. However individuals with melasma will have to do a lifetime of skin care regiment such as a high protection of sunscreen, chemical peels, fraxel laser, or prescription for hyper-pigmentation. 

Dermal melasma vs epidermal - video explains treatments

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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. If you have dermal melasma, this can be very difficult to treat, and like your doctor, every dermatologist WILL have some cases that will not respond to treatment. This is when we have to come up with combination treatments for you. 
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. In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help.
I like the Clear+Brilliant with ascorbic acid and twice a week HQ to maintain. Finding the combination that works for YOU is the key. 
All the best, Dr Davin Lim Laser, surgical and aesthetic dermatologist Brisbane, Australia 

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.