Hydroquinone is effective for Melasma, but needs time
Melasma occurs as a result of an overstimulation of pigmentary cells in the deeper layers of the skin. Hydroquinone works by inhibiting the production of melanin at the cellular level but does little to bleach the skin. Since the pigment takes approximately 120 days to reach the skin surface, a time period of 4 months is necessary to see the results of the hyperpigmentation unless aggressive exfoliation is performed.
I recommend a strict regimen for hydroquinone and topical prescription creams that literally transform the skin and skin complexion. However, time is necessary to see the results.
Before switching to more aggressive treatment modalities, you may consider reexamining your skin program to utilize the full benefits of hydroquinone based therapies.
Further, I typically advise against topical corticosteroids for melasma as their long term use is devastating to the skin.
The 14% hydroquinone and 1% retinoid Melasma Peel
For the treatment of uneven pigmentation, deep pigmentation and melasma.
The Melasma Peel is a 14% Hydroquinone and 1% Retinoid peel used for the treatment of hyperpigmentation on the skin. It is a superficial peel designed to improve the texture and appearance of hyperpigmented skin.
Patients can expect stimulation of collagen production, improvement of skin tone and texture, and diminishment of fine lines and pigmentation.
The Melasma Peel is applied in our office and stays on for 5 hours at home. The patient then follows a week-long regimen to continue the effects of the peel for maximum results.
Topical steroid and Retin-A can help with melasma
The combination of a strong topical corticosteroid and Retin-A seem to work well for those doctors in Latin American countries that see a lot of Melasma. Superficial peels can be done as a series to help allow the medicines to reach through the skin better.