Experienced melasma dermatologists/surgeons - can anyone recommend something for me?

I have seen 4 different dermatologists regarding melasma, They all prescribed a cream to apply it on the dark patches above the cheeks on both sides I have not seen any results I am tired of This I am not sure what to do now Can any doctor or dermatologist or plastic surgeon recommend something for me I am really tired of trying creams that are not working .. Does plastic surgery remove melasma ?

Doctor Answers 3

Clear and Brilliant Laser and Melarase creams

Resistant melasma is common. I would suggest a combination of the Kareskin Brightening Kit with Melarase creams combined with Clear and Brilliant laser. 


Dr. Karamanoukian

Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Melasma- combination treatments suggested.

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 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews


Hi , Before treating melasma, it is more important to check  whether it is superficial or dermal melasma. There are chemical peels exclusively available to treat both. These peels should be done under medical supervision. Since this is a long term process, stick to your doctor who treat you.  Remember, the triggering factor for melasma is UV rays, hence protect your skin with a sunblock cream to avoid further darkening of skin.  

Karthik Ram, MRCS, DNB
India Plastic Surgeon
4.8 out of 5 stars 54 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.