I think I have Melasma. Are there treatments? Will I have this forever? I am extremely self conscience about it (Photos)

My doctor said it was from the sun and the spots where I sweat the most. I am so self conscience about it and makes me want to not go out in public. I feel that make up doesn't cover it. What can or should I do? I feel it's the only thing people notice about me. It's most visible on my upper lip, but I also have it on my cheeks and forehead. I am at my wits end!! I can't hinder my life over this! Any help would be so greatly appreciated!!

Doctor Answers 6

I think I have 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. 


H Karamanoukian MD FACS

Melasma 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. Clear and Brilliant (mini Fraxel) combined with vitamin C and peptides can also help. 

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 

Melarase creams for melasma

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I would recommend Melarase AM, Melarase PM, Melapads, and Replenish creams for the melasma. 


Dr. Karamanoukian

Los Angeles

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

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

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There are many treatments for melasma, I suggest you see an expert to evaluate your skin and determine the best combination.  Dr. Emer.

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

Combined At-Home & In-Office Treatments Can Work Well To Improve Melasma

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Unfortunately, melasma is a chronic and often recurring condition, which, for the time being at least, can be treated effectively, but not cured. The typical areas of involvement are those that you describe on yourself. The use of assiduous sun protection and the continued use of prescription bleaching agents, and there are several others besides hydroquinone, if so desired, can help to complement in-office treatments and maintain the benefits of such treatments for very extended periods of time, even years in some cases.

Successful  in-office treatments, such as a series of superficial peels with Jessner's solution, TCA (in concentrations of 10-25%), full strength glycolic acid, or  salicylic acid accompanied by at-home use of prescription bleaching preparations can be quite successful in restoring more normal and even pigmentation. Ups and downs are to be expected. Nevertheless, while there is are guarantees, in general, vigorous sunscreen use and periodic maintenance applications of bleaching preparations will help to maintain the improvements achieved via the above treatments. So, take heart and seek consultation with a board certified aesthetic dermatologist and be sure to ask to see his/her before and after photos. Good luck to you.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews


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Thank you for your question angela_orlandi. Melasma is a condition characterized by the appearance of dark patches on the skin. Common areas include the forehead, cheeks, and upper lip. It affects women much more than men. It is caused by an imbalance of hormones in the body which make the skin sensitive to the sun. It can occur during or after pregnancy, when starting or getting off oral contraceptives, etc. Melasma is a condition we control not sure. While treatments including skin care and various cosmetic procedures exists, continuous maintenance is required. Please consult with a doctor for specific recommendations. Good luck!

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.