Melasma/ Skin Discoloration

Melasma is a long-term skin condition with discolored brown patches on the face.  It is often (but not always) triggered by sun exposure along with hormones from pregnancy or hormone pills.  Dr. Brown has been treating melasma for several decades now, and she has the experience and skill needed when all the standard options have failed you. 

Melasma management is difficult and takes a long-term commitment to daily, consistent treatment along with regular prevention from further sun exposure.  Even just the simple heat of the summer can flare melasma, which is difficult for us to avoid in this area.  Despite the amazing promises on social media, it is extremely rare that one simple cream will completely cure this problem.  During your evaluation, we can lay out a treatment plan designed just for you and your skin type.  We prefer to avoid most lasers for melasma treatment, since the heat generated during the procedure can sometimes make matters worse.  However, we have a long list of possible treatment options, depending on your needs and desires.  

  1. Sunscreen/sun protection: This is a crucial daily step for melasma.  We can explain at your visit why standard chemical sunscreens are not optimal for melasma.  We have several others better suited for melasma that we recommend instead. 
  2. Topical antioxidants for further sun protection: These also protect the skin from the effects of pollution and other types of solar radiation which are not blocked by sunscreen.  Topical vitamin C is a great start, but we have much better options available to recommend. 
  3. Products to increase cell turnover: Retin-A, alpha-hydroxy acid washes, and other treatments can help with the turnover of the pigment cells, to speed up the improvement.  These can be added to the general regimen for additional benefit. 
  4. Natural supplements for extra protection: Dr. Brown prefers to offer natural options whenever possible, and we can recommend several scientifically-proven compounds that are available without a prescription.  Dr. Brown has spent years researching and evaluating the best natural treatments, and she actually takes these herself every day.  
  5. Skin lightening creams: We often recommend Cyspera 5% cream (available at the front desk or by phone at a discount), as this is a more natural and very safe option that can be used all over the face without concern.  We also prescribe a high-strength compounded 8% hydroquinone mixture which warrants more caution long-term.  These lightening creams will take several months for results, so please don't get discouraged after 3 or 4 weeks.  Stay the course!
  6. Chemical peels and Melasma Peel Brightening System: These procedures help to jump-start the lightening process for those who want quicker results.  However, they cannot be performed during the hot summer months when there is a high risk of the melasma returning.  We don't want to waste your time or money. 
  7. Tranexamic acid: This pill is FDA-approved for heavy menstural cycles, but it has been successfully used off label for several years in the treatment of melasma.  This is not an option for everyone (such as those on hormore pills), but it often has great results after several months of treatment.

Even after the skin has lightened, the treatment plan is not finished.  Maintenance is extremely crucial with melasma.  We can slowly transition to a workable long-term plan to keep melasma under control.