Best Treatment Options for Melasma

To treat melasma, which consists of dark spots on the skin, whitening creams such as hydroquinone or tretinoin can be used, or cosmetic treatments such as laser, chemical peeling, or micro-needling, guided by a dermatologist. 

Melasma is more common in regions exposed to the sun, such as the face, so it is very important to use sunscreen for whitening to be satisfactory and for no new lesions to appear. In addition, melasma can have several causes, such as hormonal changes in pregnancy, use of contraceptives, use of some medicines, or aging, for example.

Best Treatment Options for Melasma
Best Treatment Options for Melasma

Melasma is curable, and the best treatment varies according to the type, the location of the affected body and the depth of the stain, which can be superficial, or epidermal, deep, or dermal, and mixed, so it is important to talk to the dermatologist to decide the ideal treatment:

1. Whitening creams

The creams that lighten stains are very effective, as they make a long-term treatment, but with long-lasting results, and can be used anywhere on the body:

  • Hydroquinone , contains a whitening active ingredient, and should be used 1 to 2 times a day, but for a limited time, due to irritating effects on the skin, such as flaking and itching;
  • Retinoids , such as Tretinoin, Adapalene and Tazarotene used in the form of a cream or gel, are useful for reducing skin darkening;
  • Topical corticosteroids , in ointments, can be used for a short period of time, to decrease inflammation of the skin that can cause blemishes;
  • Azelaic acid , also has an effect in controlling the amount of melanin and darkening the skin;
  • Other acids, such as kojic, glycolic and salicylic acid , are present in cosmetic treatments, and are more effective when combined with other acids, to assist in lightening and renewing the skin.

The treatment time varies according to the product used and the depth of the affected skin, and the results can start to be seen after 2 to 4 weeks of treatment, which can last up to about 6 months.

Best Treatment Options for Melasma
Best Treatment Options for Melasma
Treatment of melasma with hydroquinone

2. Aesthetic treatments

These types of treatment must be carried out by qualified professionals, and are guided by a dermatologist, as they promote the removal of the superficial layer of the skin, and provide faster results:

  • Chemical peeling is made with acids, with stronger concentrations than those used in creams, to remove a layer of the skin. It can be mild for superficial melasma or more intense for deep melasma.
  • Microdermabrasion , known as crystal peeling , is a professional exfoliation technique that removes the superficial layers of the skin for a renewed appearance;
  • Microneedling , is a technique that pierces the skin with microneedles to stimulate the production of collagen and blood circulation in the skin, which can be useful to reduce some spots on the skin, in addition to reducing the wrinkles and sagging of the face.
  • Intense pulsed light is not an initial option, but it is used in some cases that do not improve with other treatments, and may even worsen the spots on the skin if used in the wrong way.

Generally, several sessions are necessary to obtain the desired result, which varies according to the intensity and depth of the melasma.

Best Treatment Options for Melasma
Best Treatment Options for Melasma
Melasma treatment with chemical peel

3. Laser treatment

The laser is a great option for treating blemishes, as it releases a heat wave on the skin, which destroys the melanin pigment, and is indicated in cases of deep melasma or that has not improved with the treatment with creams or cosmetics.

Weekly sessions are held, and the amount also varies according to the severity and depth of the stain. In addition, this treatment should be done only by a qualified dermatologist, due to the risk of skin burns.

4. Nutricosmetics

The use of some supplements can be useful during the treatment of melasma, as it supplies some deficiencies of vitamins and minerals important for the health of the skin, which may be lacking in the diet.

Some options are tranexamic acid, which inhibits substances that cause skin darkening, as well as antioxidants, such as vitamin C, lutein, collagen, carotenoids, flavonoids, selenium and minerals, which help in skin recovery, in addition to preventing wrinkles and sagging .

5. Sunscreen

It is the most important treatment for melasma, as no other treatment will be effective without protecting the skin from the sun’s rays. The sunscreen should be used with a minimum factor of 15 SPF, every day, even if the day is cloudy or the person remains indoors.

It is also important to avoid exposure to the sun during the treatment of stains, and if you are in sunny environments, it is important to replace the sunscreen layer every 2 hours.

How to treat melasma in pregnancy

Best Treatment Options for Melasma
Best Treatment Options for Melasma

To treat melasma during pregnancy, also known as chloasma, one must use sunscreen and natural moisturizers daily. Preferably, the products should be hypoallergenic and oil-free,  so that they do not cause oiliness in the skin and, thus, avoid the appearance of pimples, also common in pregnancy.

The use of whitening creams or aesthetic treatments with chemicals, acids, or lasers is contraindicated in pregnancy. In very necessary cases, azelaic acid and salicylic acid in low doses are not at risk during this period, but preferably, any treatment should be postponed until the end of pregnancy and breastfeeding.

In addition, due to hormonal changes in pregnancy, the treatment of skin blemishes is hampered, and it is also very likely that the blemishes on the skin will naturally improve after the end of pregnancy.