Does Malarase really work?

Question

For a long time I have been noticing dark pigmentation right above my upper lip. I read on here that Malarase works. So I got the am and the pm. But I haven't been seeing a difference. It's only been like 2 weeks, but can anyone tell me if it really does work? I'm sure I can't tell in 2 weeks, but I don't want to do it, if it doesn't work to beging with. And if it doesn't, can you recommend anything that does work, besides laser...over the counter i prefer. Thanks

Raffy Karamanoukian, MD, FACS · Answer

Melasma and dark pigmentation is a complicated topic and probably deserves more attention than is possible in this forum. Pigmentation is caused by sun exposure, medications, hormones, aging, genetics, and excessive heat. The pigmentation can be deep dermal or superficial epidermal, or a combination. Melarase creams include Melarase AM and Melarase PM. Melarase AM contains four active sunblocks and hydroquinone free skin lighteners. Melarase PM contains HQ skin lighteners. The products should be used with a retinoid (Replenish) and Melapads (skin lighteners and exfoliants).Naturally, patients want to use as few products as possible, but it is important to use the entire program because each step has its rewards. Darker pigmentation takes a long time to improve, particularly if you have not controlled the sun exposure, genetic influences, and hormonal exposure. Things take time. My suggestion is to use the Replenish and Melapads and allow the process to work over a few months. Its hard to objectify results but UV studies have consistently documented improvements in patients while using the creams. Best, Dr. Karamanoukian#Realself100 Surgeon

Sheryl D. Clark, MD, FAAD · Answer

Dear mommymakeover1514:
Pigmentation on the upper lip can be due to hair removal or melasma, and the response to therapy can depend upon the cause. If it is the latter, it is critical that a sunscreen with not only micronized zinc oxide but also a tint to block radiant light be used to prevent recurrences with minimal sun exposure.
Melarase has some of these ingredients in the am cream but does not block all the UV light and radiant rays that cause the pigment to persist and recur. In addition, some of the sunscreen ingredients in this product are considered to be endocrine disrupters.
I recommend Lytera 2.0 cream. This can be combined with hydroquinone pads, up to 8% if you get a prescription or it is dispensed by a dermatologist. The best sunscreen is Elta tinted sunscreen. I believe the ingredients in Lytera are more effective in lightening the skin than those of Melarase, but there are no head-to-head studies to prove this.
This can be a tough problem for some, depending upon how deep the pigment is. Some of my patients use a properly-formulated Vitamin C cream to prevent recurrences as well as even out discoloration, as well as a retinol serum with 90% green tea polyphenols for a faster and more complete response. Some patients have microneedling with PRP if needed for more severe hyperpigmentation.
All the best, Dr Clark

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