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Melasma Treatment Steps

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.

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