Do I have melasma or sun damage, and will it go away?

I would suggest starting the Kareskin Brightening Kit with Melarase followed by Clear and Brilliant laser and avoidance of any melasma triggers. Best, Dr. KaramanoukianLos Angeles

This is difficult to answer without pictures. I recommend getting a formal evaluation with a cosmetic dermatologist. Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + brilliant, peels, microneedling/PRP, aerolase, and sometimes erbium laser (coollaser) to get the best results. Melasma will need life-long maintenance. See an expert for a formal evaluation. Best, Dr. Emer

In addition to reducing sun exposure, modification and disontinuation of BCP and other hormones, adequate sun protection, recommend Melarase cream.A picture post would better help in providing guidance.H Karamanoukian MD FACS

dpk88,
Thanks for your question.  Pictures would be very helpful, and an exam much more so, though what you are describing sounds like melasma.  You should stop tanning and use aggressive sun protection with SPF to prevent even more damage, and stopping birth control may help, as melasma is a hormone-dependent process.  However, you first need to find out what you have before treating it.  I personally use a combination of fractional and ablative erbium laser skin resurfacing to treat melasma, though it usually takes multiple treatments.  Good luck!

Hi there,Melasma is sun damage typically coupled with hormonal issues, so you get irregular dark patches on your skin and upper lip. They typically do not go away, and over time they get worse. You need to never touch a tanning bed again, as you already stated. You have not included a photograph, therefore it is not easy to assess exactly what is going on with you. You need to go seek the assistance of a board certified dermatologist who could look at you and do a Wood's Light test to see how deep your melasma is. Many people with melasma have been successfully treated and have been able to stay on birth control, others have to come off of birth control permanently. On a personal note, I have melasma and I wear sunblock everyday rain or shine January through December. I reapply my sunblock every two hours and you can barely see any issues with my skin and melasma. You will need peels, you will need laser and you need to be committed to the health of your skin. Good luck Dr. Downie

An examination is needed, but if you have upper lip discolouring, probably melasma. Melasma usually likes the upper lip, and forehead, as well as under your eyes, around the cheekbone. There are many variations of this pattern, and a close clinical examination will be needed for an accurate diagnosis. Melasma can not 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. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams.

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia