Is dermal melasma on Asian Indian skin treatable?

Yes. You are an excellent candidate for Permea by Solta. I suggest using ZO (Dr. Zein Obagi's line) Melamin AM-with Sunscreen, and Melamix-mixed with Retin-A 0.05%PM for 4-6 weeks prior to tx. For optimal results, you'll need to do laser 4 times minimum with 4 weeks in between. Be well#laserandmelasma   #hydroquinone   #therapy

Thank you for your question.  Skin discoloration is a very prevalent problem in women over the age of twenty.  It is also increasingly common in men with increased sun exposure.  
Risk factors include thyroid disease, sun exposure, hormones, pregnancy, family history, PIH, and birth control. Melarase AM and Melarase PM have been extremely effective in reducing pigmentation associated with skin discoloration and hyperstimulation of melanocytes. 
In my practice, patients with hyperpigmentation benefit from twice daily application of the creams. Melarase AM in the morning, followed by Melarase PM in the evening. Melarase AM contains four active sunblocks, so sunscreen is not needed unless your sun exposure is very high or you had a recent procedure/laser. SPF of 30. Melarase PM contains active skin lighteners to even out skin pigmentation. If you are concerned about the development of pigmentation, contact our office to discuss details and to obtain a regimen for Melarase. 
Recommendations:  5-step Daily Brightening Kit has everything you need to improve dark spots, skin discoloration, melasma, and hyperpigmentation caused by sun exposure, hormones, scarring, and the environment. It’s a powerful daily brightening kit that can help bring out your skin’s natural, healthy glow. Ideal for use on the face, neck, and hands. 
Includes: Melaclenz, Melapads, Melarase AM, Melarase PM, Elevase, and Spectrase
Best, 
Dr. Karamanoukian
Los Angeles

You can get improvement but there is no cure. It can always flare and needs a short and long term treatment plan.  Best, Dr. Emer.

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