Need assistants with my pesky melasma. Any suggestions? (photos)

I have had melasma on my upper lip for the last 2 plus years. Absolutly nothing seems to help reduce the appearance. I have medium dark skin, I use 30 spf sunscreen DAILY and full coverage foundation which doesn't really hide it. I have use IPL laser, chemical peels, and hydroquinone 4% with tretinoin cream with no results. What other options are there!? Please any suggestion or doctor referrals would be greatly appreciated I am tired of people thinking I have a mustache!!

Doctor Answers 5

Pesky melasma

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Melasma needs long term commitment with skin care and avoidance of skin factors such as sun exposure (Spectrase Sun Block) which has wide UV spectrum and SPF 30+ protection. 

Daily good habits with topicals may well help you chieve your goals with a good skin system like the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 

Melarase AM is non hydroquinone based. 

Clear + Brilliant laser can be added once you start your pretreatment with topicals. 

Chemical peels by an expert may also help. 

Best

H Karamanoukian MD FACS

Melarase creams and melasma

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I would first begin with the Melarase Brightening Kit to prep the skin and lighten melasma, followed by fractional laser to remove stubborn pigmentation. 

Best, 

Dr. Karamanoukian

#Realself100 Surgeon

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Melasma needs combination treatments

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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. Personally I do not like IPL as this can treat epidermal melasma, but it often worsens melsama for most patients. 

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

Melasma and Sun Spots -- Best Treamtent Is Clear + Brilliant / Fraxel 1927 with Microneedling PRP, Pro Yellow is Useful

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I suggest seeing an expert, there is no "cure" for melasma but there are lasers, skin care, peels, microneedling/PRP that can help improve the skin.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Melasma and Best Treatment NYC

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I would recommend Cosmelan for your melasma.  I have had great results with this treatment and of course avoid sun after this treatment.  Best, Dr. Green

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.