What is the best to remove dark patches in my face? Can I have glutathione injections for melasma? (Photo)

Question

My problem is melasma in my 2 cheek i try a lot of whitening products,peeling for my skin .my face is whiten but the melasma in my face like a map in my face.please let me know what is the best to do

Harold J. Kaplan, MD · Answer

Hi Shawie, we use up to Hydroquinone 8% for our Melasma cases.  To see examples for our Los Angeles patients, click on the before and after photos at the link below.

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

There is no "cure" for melasma but there are great treatments. We are doing a clinical trial now on clear + brilliant with bleaching and microneedling and getting amazing results. I suggest you see an expert. You will need lifelong treatment, sun protection, skin care. But these treatments can give you improvement and then you maintain. Best , Dr. Emer.

Edward E. Dickerson, IV, MD · Answer

Thank you for your question. The glutathione injections are growing more popular in Africa and Asia but have not quite became popular in the United States. I would recommend having a consultation with dermatologist  or facial plastic surgery. However some options that could help with dark patches are laser fraxel treatments, chemical peels, or a prescribe cream of that helps with hyper-pigmentation.

Davin Lim, MBBS, FACD - Account Suspended · Answer

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. As for glutathione injections, they are popular in Asia as a skin lightening agent, but more effective treatments are available for melasma- see below. 
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. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams. 
  
In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient. 
  
All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia

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