Does lighter melasma respond better to treatment?
Doctor Answers 3
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. In most cases experienced dermatologist do not use the Wood's, as we can tell with the colour the location of melamsa. In reality, melasma is always mixed ie. dermal and epidermal. Dermal melasma has a greyish look, and a dermatoscope I find is more accurate than Woods light. If this is light pigmentation, it does suggest its primarily epidermal, and easier to treat.
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.
More information on available treatments in the Web Reference below. All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.
Melarase creams for melasma
If you are out in the sun, this could become worse
It does sound like you have the beginnings of melasma and it is a good idea to limit your sun exposure if at all possible. You can use something like the Obagi regimen (FX is a good one to start with as it is mild and doesn't have 4% hydroquinone). Good luck and consider using a really good sunscreen such as EltaMD Sport for your times when you must be in the sun!
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