What Is The Best Way To Treat Melasma?

What Is The Best Way To Treat Melasma?

Treatment options for melasma include topical medications – lotions, creams and gels or medical procedures such as lasers, chemical peels and microneedling, sometimes even dermal fillers.

What causes melasma on face?

Melasma is a form of hyperpigmentation that primarily affects women and especially more so for those with darker skin. It is triggered by UV exposure as well as hormonal influences. The latter is what distinguishes it from traditional hyperpigmentation and makes it tougher to treat.

Melasma is caused when there is over-production of the pigment melanin. This skin condition usually occurs due to hormonal changes (pregnancy, taking birth control pills or hormone replacement therapy (HRT)) or other factors such as UV exposure, family predisposition and age. Incompatible product skincare could potentially trigger the development of melasma on the skin as well. Endogenous hormones during pregnancy can stimulate the melanocytes into producing more melanin pigments. Taking birth control pills and undergoing hormone replacement therapy (HRT) causes imbalance the current hormone levels, so melanocytes are producing more melanin than it should. Same goes for UV exposure.
If any family members are diagnosed with melasma, there are chances that this skin condition might passed down to the other generations.

Signs and Symptoms

The symptom can usually be seen with naked eyes. Dark spots and uneven skin tones, followed by discoloured patches of skin at the upper lips, bridge of the nose, cheeks and forehead are all the signs needed to confirm the development of hyperpigmentation on the skin. In certain cases, such signs are obvious on arms and neck. At times, there are confusion if the symptoms of melasma are related to other skin conditions. To be sure, it is recommended that you seek professional advice, by a qualified skin doctor or medical aesthetician. The usual test is via a skin biopsy procedure.

Can you get rid of Melasma?

There are ways that melasma can be reduced but it is known to reoccur even after a successful treatment. The typical treatment is via tropical medication with hydroquinone while for lasers and peels, it is highly dependent on individuals. In short, not all treatments work for everyone and there is no guarantee of success.


This process could either be accomplished by the use of laser therapy, intense pulse light or chemical  peel. The cost of the treatment are costlier than creams and potential side effects may include inflammation, irritation and a burning sensation..

Laser therapies (PICO, Q-Switched, Tixel, Sylfirm) 

Laser treatments are more precise than chemical peels. In laser therapies, high-energy lights are used to target the affected area as it removes hyper-pigmented skins cells at the surface or deeper level, depending on condition severity.

Chemical peels

Glycolic acid (AHA) is used frequently by dermatologies for chemical peeling. It induces the top layer of the skin to blister and subsequently peel off. As the skin sheds, new, unblemished skin will be revealed.


To regulate skin colouration, here are the few ingredients typically present in topical medical or skincare products to treat melasma.


Hydroquinone is the most common ingredient used by doctors in treating melasma. It in the form of lotion, cream or gel and is to be applied directly to the infected area for the purpose of lightening up the colour of the skin patches (bleaching). It is effective in decreasing the formation of melanin in the skin too. This is considered as the best lightening agent but it should only be used under strict medical supervision.


Arbutin is a natural source of hydroquinone responsible to induce skin lightening to fade or lighten the hyperpigmentation. It is not as strong and effective as hydroquinone but it poses lesser risks and hence are safer for patients.

Glycolic Acid (or hydroxyacetic acid)

Glycolic acid is another common active ingredient in many hyperpigmentation over-the-counter topical creams.

Kojic Acid

Kojic acid is used regularly in health and beauty products. It is responsible to lighten skin and treat certain skin conditions such as sun damage, scars and age spots. Kojic acid is a great lightening agent due to its ability to affect melanin production. However, this ingredient was recently banned in many countries.

Vitamin C derivatives

Vitamin C derivatives have been shown to hinder the production of melanin. It helps to fade dark spots and contributes to create even-toned complexion. Vitamin C derivative is often used with other active ingredients to treat hyperpigmentation.

Retinoic Acid

Retinoic acid is an effective ingredient to treat hyperpigmentation but it can potentially trigger side effects such as irritation, increased sun sensitivity, erythema, dryness and scaling. In addition to that, it might cause birth defects for pregnant or breastfeeding women. 


B-resorcinol is an effective ingredient to reduce the production of melanin. It has been clinically proven to reduce dark spots in just four weeks as it is a strong inhibitor of tyrosinase (the enzyme that forms melanin). It has little to no minimal side effects to the skin and is effective in treating major hyperpigmentation conditions such as melasma and age spots.

Additional treatments

In order to stop further hyperpigmentation, the use of broad-spectrum sunscreen with a high SPF in daily skincare routine is an effective solution.

Can oral creams treat melasma?

To prevent further hyperpigmentation, it is recommended to use a broad-spectrum sunscreen with a high SPF in our daily skin-care routine.

Conclusion/ Final Thoughts

In conclusion, melasma can be treated effectively but there is no guarantee of success despite the numerous procedures available currently. It is advisable to consult with an experienced medical aesthetician to set expectations right. The same procedure may product different results for different individuals so it is best to have a tailored program and to monitor your progress closely with your attending medical aesthetician.

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