What treatment is best for melasma and sun spots?

41 y/o Latina, med color skin tone, easily tans, rarely burns. What treatment would be best? Laser (what kind?) hydroquinone, retin A? Mixture of all 3?

Doctor Answers 9

Melasma specialist in Los Angeles

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Melasma needs long term commitment with skin care and avoidance of skin factors such as sun exposure (Spectrase Sun Block) which has wide UV spectrum and SPF 30+ protection. Accutane sensitizes your skin to injury from sun rays. 

Daily good habits with topicals may well help you chieve your goals with a good skin system ike the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 

Clear + Brilliant laser can be added once you start your pretreatment with topicals. 


H Karamanoukian MD FACS

Kare Skin Brightening Kit with Melarase

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Specific solutions for your melasma include Clear and Brilliant laser, Kare Skin Brightening kit with Melarase, and light chemical peels. 


Dr. Karamanoukian

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Treatments for melasma

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Thank you for your question Mich90650. Melasma is a condition characterized by the appearance of dark patches on the skin. A combination of products and treatments often works best. Topical products include hydroquinone, retinoic acid, glycolic acid, salicylic acid, lactic acid, vitamins C and E, kojic acid, alph-arbutin, and licorice extract. Treatments include chemical peels, laser resurfacing, IPL, fractional lasers, Q-switched laser, and topical hydroquinone treatment. Please consult with a doctor for specific recommendations. Good luck!

Melasma and sun spots

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Thank you for your question. Some options that could help with melasma and sun spots could be using the fraxel laser, wearing a high protective sunscreen, chemical peels, and a prescription cream that has liquid hydroquinone 8% solution. 

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 reviews

What is the best treatment for melasma and sun spots?

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This is a great question! Melasma is a tough problem to treat. Some things to think about…hydroquinone is a prescription and can only be used for a short time. Cosmeceuticals which use botanicals are safer for long term use. Our favorite is SkinMedica Lytera. Caution—Begin gentle, start with using this product 2-3 days a week and build up to twice every day. Retin-A makes the skin more sensitive to sun. Always use sunscreen! At Key Laser we only use PicoSure Focus on patients with medium to dark skin, with great success. We recommend using SkinMedica TNS Recovery Complex after treatment. 

Douglas J. Key, MD
Portland Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Best treatment for melasma and sun spots

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Usually a combination of hydroquinone and Retin-A is recommended for nightly use along with a high SPF sunscreen. If topical treatment is deemed unsuccessful, a round of chemical peels may be appropriate.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Mixture of lasers and creams for melasma.

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Personally I would start you on creams, yes, HQ and vitamin A. I would wait 2-3 weeks, and then use the Picosure for your skin type. This can treat BOTH melamsa and also sun spots. 

Another gentle laser is Clear and Brilliant. I do not like using Fraxel, as it is too harsh. You will require 3-5 sessions for best results. 

All the best

Dr Davin Lim
Laser and aesthetic dermatologist
Brisbane, Australia. 

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

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I suggest seeing a cosmetic dermatologist with expertise in skin care and lightening.  There are many combinations to help.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Sun Spots & Melasma

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Hi Mich.  You were correct when you noted a combination of treatments.  We use lasers for sun damage and are able to permanently remove it.  

Melasma is is very different.  It is a chronic (incurable) condition and so we help our patients manage it with a customized liquid hydroquinone 8% solution.  

To see examples below if Los Angeles Patient's that have had Melasma treatments click on the link below.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.