What can I use for melasma with a Latino dark skin?

I'm a Latino medium dark skin. I had notice dark spots on my above my lip like six months ago. I went to a dermatologist and he gave me hydroquinone 4. It helped in the beginning but three months later I have two small spots that they don't clear out. I don't know what to do now? What can I try next?

Doctor Answers 3

Melasma treatment for darker skin types

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. In some cases I combine glycolic AHA peels,low strength TCA and in other cases I use a tablet called Tranexamic acid to help. To help reduce the chances of recurrence and rebound I am now starting to use the Clear and Brilliant laser with ascorbic acid infusion on a monthly basis, and Lytera 2-3 times a week. 
All the best, Dr Davin Lim Laser, surgical and aesthetic dermatologist Brisbane, Australia 


Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

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

There is no "cure" for melasma but there are great treatments. We are doing a clinical trial now on clear + brilliant with bleaching and microneedling and getting amazing results. I suggest you see an expert. You will need lifelong treatment, sun protection, skin care. But these treatments can give you improvement and then you maintain. Best , Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Early treatment is best!

I am glad you asked your question! The melasma is brought to you by heredity and sunlight and it is a very common complaint in my practice. Patients ask me to prescribe hydroquinone, because they have had it before when they come in to my office for the first time. 
I don't use this drug for melasma because it seems to do exactly what you mentioned. Because HQ is a bleach , they say only put it on the dark areas!.
 More dark areas keep coming  when patients are not schooled in the IMPORTANCE OF SUN PROTECTION. The sunlight doesn't stop ....thus melasma treatment is not effective unless you use SPF at least 45, every day of your life. Sunny, rainy, cloudy or days you arent  going anywhere are STILL days to apply sun protection.
I use different a approach and try to get patients to understand that we TREAT but don't cure. Much like diabetes or hypertension, you must keep doing what you did to get the skin clear with effective creams and SUN PROTECTION faithfully.

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon
4.9 out of 5 stars 7 reviews

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