Treatment For Melasma That Won't Lighten My Entire Face?

Is there a peel or other treatment I can do for dark spots (melasma) that won't lighten or bleach my entire face? 

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F, New Hampshire

Tags:woman options dark spots peeling melasma

As it stands, it’s impossible to completely cure melasma, as even the smallest amount of UV light can potentially lead to hyperpigmentation. Regardless of which melasma treatment you use, there's always a risk that your melasma could return.

However, it’s not all doom and gloom. There are a variety of melasma treatment options that can reduce dark spots and improve the complexion of your skin.

One of the most common treatments is hydroquinone, a compound that is widely used in skin lightening products. Hydroquinone can be found in topical creams, gels, and liquids. Depending on the amount of hydroquinone they contain, hydroquinone creams can be purchased over the counter at your local drug store. For stronger depigmenting products, you would likely require a prescription from a dermatologist.

You might also consider Cysteamine Cream. Made by Scientis Pharma, Cysteamine Cream is a skin lightening product that contains cysteamine hydrochloride, a strong depigmenting agent. A placebo-controlled clinical trial published in the British Journal of Dermatology showed that Cysteamine Cream can be used to effectively treat melasma.

Alternatively, your dermatologist may recommend using azelaic acid, kojic acid, tretinoin or corticosteroids, depending on what your skin requires. Some people are able to achieve great results with depigmenting cream but, if symptoms persist, your dermatologist may recommend a procedure such as laser treatment, chemical peel, microdermabrasion, and more. In my experience, the best results come from using a multi-layered approach to melasma, so do be prepared to employ a combination of treatments.

I urge you to book a consultation with an experienced dermatologist to learn more about which type of depigmenting treatment is best suited to you.

Treatments for Melasma have been well studied in the dermatology space, and there are many treatments that will work to not only lighten your dark patches or dark marks, but to improve the overall tone and texture of your skin. Chemical peels, which are generally broken into three distinct groups based on their depth of treatment (superficial, medium, and deep), are excellent treatments used for Melasma. Several, spread apart in-office peels, depending on their potency and your sensitivity to their ingredients, will aid in making the dark spots fade. In addition to chemical peels, products like Skin Medica's Lytera 2.0 (available at select physician offices), a serum used to treat dark marks and Melasma, contains tranexamic and potent antioxidants. This therapy is applied all over the face and decollate for a gradual improvement of skin tone. Tranexamic acid can also be taken orally for difficult to treat Melasma. The oral medication comes with some side effects, medical history and family medical history questioning, and pre-treatment blood work, but has shown to have remarkable improvements for those suffering from recalcitrant and severe Melasma. Lastly, a newer treatment available to patients through a physician's office is Cysteamine Cream. This cream is applied to the face at night and washed off shortly thereafter. It has been proven to be effective in reduces melanin pigment without impacting normal-toned skin. In fact, none of the above mentioned treatments should cause a lightening of the normal-toned skin. Previously, Hydroquinone was one of the only topical therapies used to treat Melasma, which could "bleach" the normal-toned skin or cause a "halo effect" of lightening around darker marks or darker patches. It is most important to note that even if you are able to correct your Melasma effectively, broad spectrum SPF 30 or more should be worn daily and reapplied throughout the day - just 5-10 minutes of unprotected skin exposure to UV rays could reverse all your hard work (and money) in correcting your irregular pigment. Be sure to have an in-depth conversation with your medical provider before starting any at home or in office therapies used to treat your Melasma.

Dr. Jeanine Downie has 1 Fraxel Laser before & after:

Fraxel Laser before image performed by Dr. Jeanine DownieFraxel Laser after image performed by Dr. Jeanine Downie

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