My melasma has occurred due to external factors, does this mean that I can maintain clearance of melasma using strong SPF?

I first got melasma when I was on BCP for 4 years, and started using obagi for acne spots. I went on holiday and didn't wear sunscreen while still using rest of the obagi products. I developed melasma on upper lip after laser hair removal. I am indian. I never got any spreading of melasma without external triggers.It never got worsen after the initial onset until I had laser. Does this mean that it should be possible to maintain results of treatment easily since there may not be any internal triggers?

Doctor Answers 7

Melasma and Lasers

I treat so many patients with melasma who unfortunately had laser therapy which made them worse.  I definitely do not like laser treatment for most cases of Melasma.  Cosmelan therapy is fantastic for clearing the melasma along with bleaching creams and chemical peels.  Please consult an expert for the best treatment. Best, Dr. Green

New York Dermatologist
5.0 out of 5 stars 78 reviews

Melasma and treatment.

The exact cause of Melasma is UNKNOWN..

It is likely not caused by laser. What you are experiencing is most likely hyperpigmentation. If you had recent sun exposure prior to having laser hair removal, your melanocytes where active, and having laser on top of already active melanin can cause hyperpigmentation. This is usually transient, which means it will subside on its own with good SPF and avoiding the sun. You can use a prescription cream called hydroquinone, for about 3 months and see if that makes a difference.

We have a great laser option for your Indian skin type called the Permea/Clear+Brilliant by Solta. By doing this 3-4 weeks apart; I recommend having a series of 3, you can greatly reduce the appearance of fine lines, wrinkles, pore size, and any brown pigmentation as well as true Melasma.

#laser   #pigmentation #melasma

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Sunscreen use and melasma

Yes! High SPF sunscreens will for the most part prevent recurrences of melasma. Of course, sunscreen alone will not just do the job. Sun avoidance between the hours of 10am and 4pm and wearing sun protective clothing and a wide brim hat will help also. 

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
4.9 out of 5 stars 20 reviews

Melasma treatment and management

Hyperpigmentation caused by laser hair removal post procedure is different than melasma.  Melasma is a much deeper patchy color and much harder to treat.  Melasma can be caused by many factors such as hormone, pregrancy and prolonged exposure to sun over time. 

Melasma can be managed by combination of topical and office treatments.  Combining treatments of Q-Switch laser that doesn't use heat to further aggrevate the melasma in combination with glycolic peels and topicals of hydroquinone and Retinol prove to be effective in treating and managing Melasma.

Post procedure hyperpigmentation caused by such as laser hair removal can also be treated with hydroquinone and Obagi makes a product called Nuderm with hydoquinone that can be applied to the effected areas for a course of time.  If you continue receiving laser hair removal you may want to talk to your doctor about the setting that is being may be too much for your skin type thus causing hyperpigmentation.

David P. Melamed, MD
Los Angeles Dermatologist
5.0 out of 5 stars 8 reviews

Melasma treatment and maintenance plan is essential

Melasma is one of the more difficult conditions to treat. 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

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

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

Unfortunately this will take a series of treatments for improvement and melasma can flare at any time.  You need a long term solution, and short term plan.  Please see a cosmetic dermatologist with experience for sun protection, skin care, peels/lasers etc.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Treatment & Prevention of Melasma

First, you are confusing different things. Melasma is caused by various bodily reactions, such as hormonal changes. The dark areas from the laser is what is called post traumatic hyperpigmentation. The sun causes dark spots that are sometimes large and sometimes just freckles. Nothing can actually prevent Melasma. You can, however, prevent post traumatic hyperpigmentation by pretreating with hydroquinone or the Obagi System for at least 6 weeks before the laser or peel, etc. You can also prevent sun damage by use of a good sunblock, but relying on SPF is NOT what you should do. The pigmentary abnormalities are caused by UVA. SPF indicates only UVB protection. Not all UVA sunblocks are equal either. The best ingredient that is the most practical is zinc oxide. I tell my patients to look for 8-12% of Zinc Oxide and forget the SPF, as the zinc also protects from UVB. Additionally, it does not have to be reapplied unless you rub or wash it off. Others should be reapplied every 1-2 hours. All the problems above can be treated by the OBAGI Nu-Derm System.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
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.