How to remove freckles and melasma permanently? Any cream? (Photo)

There is no cure for melasma despite lasers, skin lightening, needling/PRP.  I suggest you see an expert in lasers and skin to get improvement.  Best, Dr. Emer.

There are many precipitors for melasma and pigmentation. I would start with the Melarase Brightening Kit with Melapads, Melarase AM, Melarase PM, and Replenish; followed by a combination of Covalent peels, Yag laser, and light fractional laser. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

I personally would avoid all lasers for melasma and consider a dermatologist who performs Cosmelan treatment.  I have treated so many patients who suffer from hyperpigmentation from lasers with dark skin and have found that the best treatments are chemical peels, bleaching creams, and Cosmelan peels.  Please consult an expert.  Best, Dr. Green

The vi peel is safe on any color of skin and is effective in reducing melasma in one week with no downtime. Although it is not permanent it can be repeated in a 3-6 months if necessary. The use of a sunblock along with bleaching cream if necessary can maintain the effect.

Melasma can no t 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. Fraxel in a low dose setting, together with creams can also help. What ever you do, do NOT use IPL as this treatment, though effective for freckles can make melasma worse. 

In some cases I combine glycolic AHA peels, and in other
cases I use a tablet called Tranexamic acid to help.

All the best,

Dr Davin Lim

Laser, surgical and aesthetic dermatologist

Brisbane, Australia

Both melasma and freckles are caused by UVA sun exposure with heredity and hormones thrown in to worsen the sun damage. DermaClin Forte is a hydroquinone cream that changes the way the melanocytes (the pigment cells) work to reduce the spots and prevent new ones. Unfortunately, you will probably need to use the hydroquinone somewhat continuously to prevent recurrence of the problem. I have personally been doing so for over 25 years (using the Obagi Nu-Derm System with hydroquinone). When I switched to another product, the spots returned in about 9 months but again disappeared again in 3-4 weeks after restarting the Obagi. Additionally, you need a good 8-12% Zinc Oxide sunblock DAILY as it is the only practical sunblock available. It needs to be reapplied only if rubbed or washed off. The other sunblocks that block UVA all need to be reapplied every 1-2 hours depending on whether you are indoors or out. (See PlasticSurgeryToday.com/beautifulskinlaserresurfacinghighlandsnorthcarolina/obagi-nu-derm/)