Is there a ip melasma treatment? (Photos)

Question

Over the past few years I have developed brown areas / spots on or around my lips. Is there a corrective treatment I can pursue, or should I instead look at something like lip blushing?

Anna Chacon, MD, FAAD · Answer

Melasma that appears around the lips—sometimes called perioral melasma—is less common than on the cheeks or forehead but can still be treated effectively. Based on your description, these brown patches could be hormonally driven pigmentation or even post-inflammatory hyperpigmentation if there was past irritation, trauma, or cosmetic treatments.

First-Line Treatment Options:
1. Topical Lightening Agents
Hydroquinone 4% (prescription) remains a gold standard.

Alternatives: Azelaic acid, kojic acid, niacinamide, cysteamine, or arbutin—especially for sensitive areas like the lips.

Custom-compounded blends like Kligman's formula (hydroquinone + tretinoin + a corticosteroid) can be adjusted to suit the lip area.

2. Chemical Peels (Mild)
Low-strength glycolic acid or lactic acid peels can help fade pigmentation gradually.

Should be applied cautiously near the lip margins due to sensitivity.

3. Laser Treatments
Devices such as PicoSure or Clear + Brilliant can target melanin in superficial layers, but melasma is notoriously prone to rebound.

Use only under the care of someone experienced in treating melasma, particularly in darker skin types, to avoid worsening the pigment.

4. Strict Sun Protection
Daily use of broad-spectrum mineral sunscreen (SPF 50+) is essential—even on cloudy days.

Use lip-specific sunblock or balms with SPF as well.

Cosmetic Option: Lip Blushing
Lip blushing is a semi-permanent tattooing procedure that can neutralize pigmentation, especially if hyperpigmentation is stubborn or resistant to treatment. While it won’t address the underlying pigment process, it can camouflage discoloration with natural tones. However, this is best reserved after confirming that the pigmentation is stable and not progressing.

My Recommendation:
Start with topical therapies and sun protection. If no significant improvement is seen after 8–12 weeks, consider combining with a mild chemical peel or laser treatment under medical supervision. Lip blushing can be considered later as a cosmetic option if you're seeking a uniform appearance rather than reversing the pigment process itself.

Melasma is chronic and can recur, so ongoing maintenance with pigment inhibitors and sunscreen is key.

Is there a ip melasma treatment? (Photos)

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Is there a ip melasma treatment? (Photos)

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