I've had melasma for many years, tried everything, peels, vitamin c. Can you suggest an alternative?

Question

Can you tell me what I should be using it used to be all over my face. Now it is just on my cheeks and forehead. I have been using lemon and baking soda. I don't to get laser. The lemon and baking soda seems to be helping a little bit. thanks for your time.

Harold J. Kaplan, MD · Answer

Hi Gritt.  It sounds like you may be using over the counter remedies rather than prescription medications to treat your Melasma.  Lemon juice and baking soda will not work to help treat the condition.We use 6% - 8% hydroquinone in liquid format with a 3 month treatment period and one month resting.  The protocol works very well to control Melasma.  The key term being control since you cannot cure Melasma.  We have used lasers in the past and about 50% of our patients got worse after treatment, so we would never recommend any laser treatment for Melasma.  It's more risky, more expensive, more time consuming and does not offer a cure.  To see examples of before and after pictures of our Los Angeles and Orange County Melasma patients, click the link below.

Raffy Karamanoukian, MD, FACS · Answer

Melasma can make your skin look mottled and hyperpigmented. Melasma is usually caused by endogenous and exogenous hormones, the sun, inflammation, and possibly thyroid dysfunction. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of light fractional laser, depigmenting lasers and IPL, vascular pulsed dye laser, and Covalent peels. 
  
Recommended Creams: Melarase Brightening Kit
  
MelaClenz
  Melarase AM
  Melarase PM
  Melapads
  Replenish Retinoid Cream
  Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Shim Ching, MD · Answer

We use a combination of Tri-Luma and Revlite laser at a low setting with great results.  You will need multiple treatments and you also need to avoid sun exposure.

Mike Majmundar, MD · Answer

Not knowing what brands of products you have tried, I would first suggest that you get on medical grade products.  These are stronger and will have higher percentages of the active ingredients than over the counter products.  I would suggest trying a Mini Melange Peel.  These peels are for all skin types and give great results.  You may need 2-3 peels, depending on the depth of your hyperpigmentation.

Jason Emer, MD · Answer

Avoid any lemon as it makes your skin more sensitive to the sun and baking soda is just bad for the skins health. I suggest getting on a much better topical regimen and adding sunscreen. Clear and brilliant laser is doing wonders for my patients! Try that but only with someone who knows lasers well. If not done right the melasma will flare.  Best, dr e.

Joshua L. Fox, MD · Answer

I would avoid use of lemon juice and baking soda. It can worsen the melasma. I would recommend a hydroquinone, tretinoin combination with use of sunscreen daily. The strength of the hydroquinone would depend on skin type. Follow up in 8-12 weeks. If mild there is mild improvement I would recommend adding chemical peels to the regimen.

I've had melasma for many years, tried everything, peels, vitamin c. Can you suggest an alternative?

Answers (6)

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