How to maintain results of melasma treatment?

I am using strong hydroquinone 10%+kojic acid 4% + tretonin 0.1% + steriod to clear up dermal melasma on cheeks and upper lip. I worry about getting all melasma back after i discontinue use of the cream. Can the clearance be maintained , how?

Doctor Answers 2

Clear +Brilliant and melasma

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.For maintenance therapy, I like the of Clear and Brilliant with vitamin C or low strength TCA Peels with HQ 2 times a week. 
All the best, Dr Davin Lim Laser, surgical and aesthetic dermatologist Brisbane, Australia 

Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Melasma recurrence

Thank you for your question. Unfortunately, there are no specific treatments or interventions available to maintain clearance of melasma. The best prevention is to use sunscreen SPF > 40 and sun protection on a daily basis because any unprotected sun exposure may result in melasma returning. With that being said, other factors may also cause melasma such as hormones, medications, or other underlying diseases. I recommend you consult with a dermatologist regarding your questions and concerns. Take care and good luck.

Reuel Aspacio, MD, FAAD
Las Vegas Dermatologist
5.0 out of 5 stars 6 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.