Melasma is a common condition that many women experience. It is a pigmentation on the skin thought to be caused by a combination of sun exposure and female hormones. The most common areas for melasma to present are the forehead, cheeks, and upper lip. Although melasma seems to develop quickly, it can often be frustrating to eliminate. The key factor to keep in mind when treating melasma is to be diligent with sun protection. Women with melasma must wear a broad spectrum sunscreen daily and reapply every time they go outside. Additionally, we recommend that women with a history of melasma wear a hat while spending time outdoors in direct sunlight.
There are many treatments available to help us get rid of melasma. The most commonly used prescription medication is called hydroquinone. Hydroquinone works by blocking an enzyme that is necessary for pigmented cells in the skin to form; without this enzyme, the excessively pigmented areas of the skin tend to lighten to match the normal skin tone. However, many women have tried hydroquinone in the past and are interested in alternative options for treating their melasma. Here is a list of non-hydroquinone treatments that can help to get rid of melasma:
- Retinoids – Retinoid creams (such as Retin-A or tretinoin) stimulate skin cell turnover, so that the pigmented cells of melasma are sloughed off and healthy skin remains.
- Azeleic acid – Azeleic acid (commonly used under the brand name Finacea) is an acne and rosacea medication that has been proven to simultaneously lighten areas of excess pigmentation.
- Chemical peels – Tareen Dermatology recommends a chemical peel called the Mini Melanage Peel for patients with melasma. This peel is actually an entire system (it combines an in-office peel with an at-home lightening regimen) that was developed to get rid of melasma.
- Lasers – Certain resurfacing lasers can effectively treat melasma in the right patient, by stimulating the production of healthy, non-pigmented skin in place of the dark spots of melasma.