How to remove melasma from chest area?

Hi CC.  Melasma does not normally occur on the chest.  It's very likely that what you are describing is a condition called Poikiloderma.  Poikiloderma is a darkening of the neck and chest related to long term sun exposure that normally occurs in lighter skin types.  It can have both vascular (red) and pigmented (brown) components to it and therefore we use both pulsed dye and q-switched lasers.  Although the condition is difficult to treat, lasting improvement can be had with the right type of laser technology (IPL is not a laser).

Melasma can make your skin look mottled and hyperpigmented. Melasma is usually caused by endogenous and exogenous hormones, the sun, inflammation, and possibly thyroid dysfunction. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of light fractional laser, depigmenting lasers and IPL, vascular pulsed dye laser, and Covalent peels.

Recommended Creams: Melarase Brightening Kit

MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 

Dr. Karamanoukian

Realself100 Surgeon

Melasma is a common problem that has a solution.  Depending on the severity of Melasma it can be treated with topical therapy alone, or Cosmelan (with or without hyroquinones) or chemical peels. I would suggest you consult a board certified dermatologist with experience in Melasma for the best cosmetic treatment.

Chest melasma is uncommon, but could occur.  Most likely if you have it on your chestyou have it on your face.   Many of the topical products used to treat melasma canbe irritating and the chest is always extra sensitive to topicals.  The discoloration could simply represent old sundamage and have that deep, darker color.  Individuals that freckle have less genetic protection from the sun, so physical protection from clothing is your best bet.  During the day, we recommend wearing a shirt that covers the chest.  Physical sunblocks with zinc oxide or titanium dioxide are excellent, but the direct heat and incident UV penetration can still damage the skin.  You could try some of the non-hydroquinone products, such as Lytera, but the chest may respond best to microdermabrasion with ultrasound non-HQ Bleach and Retin A or a series of light chemical peels.  It is not uncommon to have lasers and light sources create rebound hyperpigmentation.  I would definitely have you see a cosmetic dermatologist as you may need hormones checked if this truly is melasma and having rebound hyperpigmentation can be a challenging issue.

Melasma is extremely uncommon on the chest. Brown pigmentation on the chest is most commonly due to chronic mild sun exposure, such from wearing V-neck shirts. Nd:Yag laser can be very effective for this type of brown pigmentation, but often needs to be repeated once or twice every year.