Is dermal melasma on Asian Indian skin treatable?

I have been diagnosed with dermal melasma on my face. It hasn't been lifted with dermalen chemical peel and 10% hydroquinone + 4% kojic acid ( 6 weeks +) treatment. I have learnt from my research that dermal melasma is not treatable and can only be controlled using sun protection so that it doesn't spread anymore. I want to hear from doctor's experience, if you have ever successfully treated( faded it several shades) using any treatment modalities on asian/indian female? Please say yes/no only.

Doctor Answers 4

Multiple treatment can help

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

Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Melasma and Indian Darker Skin NYC

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

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Melasma on Darker Skin Types

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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

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

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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

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.