Melasma is a disorder of facial pigmentation. Melasma treatment is a multistep process. The number of steps required differ for patients, but all patients start with step 1 and then progress from there.
Step 1 – Things you can do before seeing a dermatologist
- If possible, stop the oral contraceptive pill, or switch to an intrauterine device, like the Mirena
- Apply sunblock at least twice a day, if not wearing make-up. If you do use make-up apply a good sunblock before applying the make-up
- Use an over the counter depigmenting agent at night
Step 2 – If the above is not effective after 8 weeks, make an appointment to see the dermatologist
- For milder cases of Melasma the dermatologist might prescribe Azeleic Acid cream or a retinoid cream
- For more severe cases of Melasma the dermatologist might prescribe a Hydroquinone containing cream at night
Step 3 – If the above is not effective after 8 weeks, the following treatments will be considered
- Tranexamic acid tablets has recently been investigated in the treatment of Melasma and works well in some patients
- Topical Tranexamic acid needling or Tranexamic acid intradermal injections
- Pulsed light treatments
- Fraxel laser
Once the Melasma is brought under control, the treatment falls back to controlling it, which involves Step 1 above. The treatment of Melasma therefore never actually stops, but is an ongoing process.