Is dermal melasma on Asian Indian skin treatable?

I treat many patients who have dermal pigmentation with dark skin.  It can take a long time and although I have every laser that is mentioned here I would avoid these lasers and consider only traditional chemical peels and Cosmelan therapy. Please consult an expert.  Best, Dr. Green

Yes, I have been able to shift or improve dermal melasma. Most of melsama is mixed, but if you have a grey look to the pigment, it is mainly dermal, and harder to treat. 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.

In some cases I combine glycolic
AHA peels, and in other cases I use a tablet called Tranexamic acid to help.

All the best,

Dr Davin Lim

Laser, surgical and aesthetic
dermatologist

Brisbane, Australia