Does lighter melasma respond better to treatment?

I've seen a dermatologist that told me i had melasma, but it was not that bad. He didn't use a woods lamp. The photos i've seen don't completely look like mine. It's tan and slightly pink, not clearly defined macules or dark brown. Since it's lighter, would it respond better to treatment? Which ones besides triple cream and sunscreen? I'm scared of triple cream because I have to be in the sun for my job (athlete).

Doctor Answers 3

Melasma and

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.

Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Melarase creams for melasma

I would suggest starting with Melarase AM and Melarase PM, Melapads, and Replenish creams to help reduce the pigmentation on the skin associated with melasma. Best, Dr. KaramanoukianLos Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

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!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.8 out of 5 stars 40 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.