What are the latest treatment options for dermal melsma?

i have dermal melasma all over my face please help !!

Doctor Answers 4

Dermal melasma is hard to treat, however improvement is possible. Read more.

Melasma can not be completely cured, however effective treatment are possible. Dermal melasma is one of the hardest form of melasma to treat.  This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour, additional the pigment lies deep in the skin- ie. Dermal.  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. Picosure Focus is my laser of choice, followed by the Revlite or C6, then the Clear and Brilliant. For dermal melasma, its Picosure as my first line. 

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 


Brisbane Dermatologist
4.7 out of 5 stars 61 reviews

Melasma and Best Treatment and Cosmelan

I have all of the lasers imaginable to treat melasma but I would encourage you to seek out a physician who treats the skin with Cosmelan for melasma.  It is extremely effective for melasma, especially for patients who are worse from past laser treatments.  Best, Dr. Green

There is hope.

Melasma is a condition that affects a large number of people. You are not alone. Over the counter creams over promise and under deliver. At Key Laser we are using the PicoSure Focus to treat melasma and are having great results. Treatments are performed in a series of 3 sessions about a month apart. Remember, laser treatments need some help. The additional help will come from using good products. We like SkinMedica TNS Essential Serum to repair and protect and SkinMedica Lytera for brightening, and you must always wear a good sunscreen.

Douglas J. Key, MD
Portland Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

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The latest and greatest treatments for melasma: peels, clear + brilliant, microneedling/prp

We currently use clear + brilliant with bleaching and microneedling/prp 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 165 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.