is it not suitable for dermal melasma? how about the strong formulations such as 10% strength? can that work for stubborn dermal melasma?
HQ is a bleaching cream, and reduces the activity of melanocytes (pigment producing cells that lie on the upper layers of the skin). If you have dermal melasma ( most patients have an element of mixed melasma- at least here in Brisbane), HQ does not actually treat the pigment. This is where lasers come in as adjunctive therapy. I prefer to use a combination ofcreams and laser for melasma. Hydroquinone can be used (5-8%), along withvitamin A creams. I usually start my patients on laser (low dose Q switch orPicosure) a few weeks after they commence on creams. In some cases I combine glycolicAHA peels, and in other cases I use a tablet called Tranexamic acid to help.More information on availabletreatments in the Web Reference below. All the best, Dr Davin LimLaser, surgical and aestheticdermatologistBrisbane, Australia