Best treatment for hormonal Melasma? (photos)

Hi, I have melasma quite evenly across my face. I was having q switch laser treatments which were great and then went without treatments for almost three months. I have been offered a combination of You laser MT for the vascular component and q switch or another clinic offered a combination of Mercury laser genesis using numbing cream for the vascular component and Gentlelase pro, the second clinic also said this will give a facelift and tighten the skin around my eyes which I want as well.

Doctor Answers 3

Azelaic acid cream or Melarase

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I recommend that you apply the appropriate creams to the entire face. 

Azelaic acid based creams are great non HQ creams for melasma. 

Cysteamine is a strong agent and may cause hypopigmentation especially in daark skin.

Melasma treatments are lifelong and should be tailored for each patient.

Melarase is a great regimen to add or a Brightening Kit in its entirety.

I also recommend that you add one of two of these oral supplements for pigmentary control: Scler-X PIH Relief Complex from VenaSmart or Pigmentation Correction Complex from KareSkin.

You will need wide spectrum UV protection with SPF 30+ sunblock as well. 

H Karamanoukian MD FACS

Melarase Brightening Kit for melasma in Australia

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I would start with the Melarase Brightening Kit followed by Yag laser, Clear and Brilliant laser, and light chemical peels. 


Dr. Karamanoukian

Los Angeles

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


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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.

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

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.