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How to Treat Melasma

Three Parts:Prevention and Non-Prescription Home TreatmentPrescription CareProfessional Procedures

Melasma is a chronic skin condition that causes discoloration on the face. It usually appears as brown, tan, or blue-gray patches along the upper cheeks, upper lip, forehead, and chin. The primary factors causing melasma are hormonal changes and external sun exposure, so the most effective and long-lasting treatments are aimed at these causes. Many other treatments, however, are designed to treat the discoloration itself.

Part 1
Prevention and Non-Prescription Home Treatment

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    Protect your skin from the sun. Apply broad spectrum sunscreen and take other measures to protect your skin from the sun. Doing so can prevent an outbreak of melasma and may reduce the risk of current melasma getting worse.
    • Apply sunscreen 20 minutes before you anticipate being out in the sun. Look for a sunscreen with an SPF of 30 or higher, and consider getting one with added nutrients, like zinc, to benefit your skin.
    • You could try “double” sun screening, as well. Layer an SPF 15 sunscreen on beneath an SPF 30 sunscreen for even more protection.
    • Wear a wide-brimmed hat and large sunglasses to provide your face with additional protection. If your melasma is especially bad, you might also want to consider wearing long-sleeved shirts and pants.
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    Calm down. Stress can worsen hormonal imbalances, and if a hormonal imbalance is the cause of your melasma, finding ways to stress less can help treat your melasma.
    • If you have difficulty relaxing, try techniques like meditation or yoga to help you. If these do not work for you or do not appeal to you, simply make time for more things you enjoy—whether that includes walks through the park, reading, or taking a bubble bath.
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    Look for an over-the-counter hydroquinone cream. These medicated ointments lighten the skin, causing the appearance of melasma to fade.
    • Hydroquinone comes as a cream, lotion, gel, or liquid. It works by blocking the natural chemical process in your skin responsible for creating melanin, and since melanin produces dark skin pigmentation, the amount of dark pigmentation related to melasma will also be reduced.
    • There are even hydroquinone creams that contain a little sunblock, so if you want to protect your skin while treating it for melasma, these options provide an all-in-one opportunity for you to do so.
    • Nonprescription hydroquinone creams usually have a concentration of 2 percent or less.
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    Consider a cream containing kojic acid or melaplex. Both ingredients are skin brighteners, but they tend to be less harsh and less of an irritant than hydroquinone.[1]
    • More precisely, these ingredients slow down the production of skin-darkening pigmentation in your skin. As a result, new skin cells being produced will be less dark, making it more difficult for melasma to set in.
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    Take tretinoin. This is a type of vitamin A that increases the rate at which your skin sheds dead cells. This can help patches of melasma fade faster.[2]
    • Note, however, that this alone may not cure your melasma if the underlying cause has not also been remedied. The affected skin will shed quicker, but if your body still has reason to let melasma develop, it may continue to do so even after new skin cells take their place.
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    Opt for a holistic approach. If chemicals are not your thing, there are a few natural substances that are thought to suppress pigment-producing and pigment-darkening components in your skin.
    • One of the most recommended natural treatments for melasma is paper mulberry. This plant grows as a small tree or shrub, and while it has many non-medical uses, the extract or products containing the extract can be used orally and topically to treat melasma, as long as you follow the instructions provided on the product.
    • Other ingredients that have been known to help when applied topically include bearberry, watercress, mandelic acid, lactic acid, lemon peel extract, apple cider vinegar, and Vitamin C. These are all capable of relaxing pigment-producing compounds in your skin without completely nullifying them and causing irritation or sensitivity to light.

Part 2
Prescription Care

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    Stop taking medications that could be to blame. Certain medications, like birth control pills and hormone replacement therapy, can affect your hormones and bring on melasma. Talk to your doctor about stopping these medications to see if that makes a difference.
    • Even though pregnancy is the condition most commonly associated with melasma, it has also been known to occur with medications and conditions that impact your hormones. Oral contraceptives and hormone replacement therapy are the next two most common causes of melasma, after pregnancy. You can stop use or try switching to a different product to determine if your melasma will fade naturally afterward.
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    Ask your doctor for a prescription hydroquinone cream. While some treatments containing this ingredient can be purchased over-the-counter, your dermatologist can prescribe a stronger version that will be more effective at lightening the skin.
    • Hydroquinone comes as a cream, lotion, gel, or liquid. It works by blocking the natural chemical process in your skin responsible for creating melanin, and since melanin produces dark skin pigmentation, the amount of dark pigmentation related to melasma will also be reduced.
    • Prescription hydroquinone typically has a concentration of 4 percent.
    • Concentrations of hydroquinone higher than 4 percent are unlikely to be prescribed in the United States and can be dangerous. They can cause ochronosis, a permanent form of skin discoloration. This condition is especially common in countries that prescribe concentrations of 10 to 20 percent, and usually, only patients who take these treatments regularly for several months or years will face ochronosis.[3]
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    Talk to your doctor about a second skin lightener.[4] While hydroquinone is used as a first treatment in many cases, your dermatologist might be willing to prescribe a secondary skin lightener that can help enhance the effect.
    • Tretinoins and corticosteroids are among the most frequently used secondary treatments. Both are used to speed up the body's process of shedding and replacing skin cells. Some dermatologists may even prescribe "triple creams," which contain tretinoin, a corticosteroid, and hydroquinone in one formula.
    • Other options include azelaic acid or kojic acid, which slow down the production of skin-darkening pigment.

Part 3
Professional Procedures

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    Get a chemical peel. A chemical peel is a procedure that uses glycolic acid or another similar chemical abrasive to peel the melasma-affected top layer of skin away.
    • The liquid chemical is applied to the skin, creating a mild chemical burn. As the burned layers peel off, they leave behind fresh, melasma-free skin.
    • While glycolic acid is one of the most common options used, another common option is trichloroacetic acid, which is a compound similar to vinegar.[5] Peels done with this chemical can be slightly more painful afterward, however, but they may present a good option for severe cases of melasma.
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    Discuss microdermabrasion and dermabrasion. During these treatments, the top layer of skin is gradually stripped away, leaving clean, melasma-free skin in its place.
    • Both dermabrasion and microdermabrasion are medical procedures that essentially "sand off" the surface layer of skin using abrasive materials. Microdermabrasion uses smaller materials and tends to be more thorough, however, so it is the option more commonly used nowadays.
    • During microdermabrasion, fine crystals are vacuumed across the skin. These crystals are abrasive enough to forcibly strip away dead skin cells, thereby lifting away the affected skin. You can usually get about five procedures done, each two to four weeks apart. You may also opt for a maintenance treatment that occurs every four to eight weeks if the underlying cause of your melasma has not been treated.
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    Be careful with lasers. While some laser treatments might be able to help strip away the skin affected by melasma, some can actually worsen the mask.
    • If you do go for a laser treatment, look for a restorative or fractional dual laser that only targets pigmentation on the surface of the skin, rather than that lying further beneath. You should also make sure that an experienced doctor is performing the procedure.
    • Fractional laser treatments tend to be expensive, though, and may cost $1000 or more. Keep in mind that you will probably need three to four treatments over the course of three to six months.
    • There is also some evidence that microdermabrasion and certain laser treatments can provide a safe type of therapy with positive, long-lasting effects.[6]
    • Intense pulsed light therapy is milder than laser treatment but works in a similar way. Certain light waves are targeted at the pigmented areas of the skin. These light waves remove the pigmented areas through exposure.


  • If you experience skin irritation, darkening of the skin, or other skin-related problems after you begin treatment for melasma, contact your dermatologist to determine what should be done to stop these problems.

Things You'll Need

  • Sunscreen
  • Hats, long sleeves, long pants
  • Nonprescription or prescription topical treatments

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