Melasma Treatments: Your Treatment Options Explained

close up of face showing melasma

Now that fall is in full swing and we are deep-diving into yard clean up, seasonal decorating, and not-so-distant dreams of stuffing, that golden tan should be all but gone. But, if you notice dark spots or patches lingering on your forehead, chin, nose, upper lip, or cheeks, they may be a sign that you actually have melasma.

Also known as ‘the mask of pregnancy’ (more on that below), melasma is a pigment condition that can affect women of all ages and can last for years. It’s not painful and isn’t a concern health-wise, but melasma can cause a lot of anxiety. Not everyone is comfortable with their appearance, particularly with very visible skin discoloration.

Melasma is commonly tied to pregnancy because it often shows up on pregnant women whose hormones are in flux. It is said to be triggered by an increase in hormones, which is why it is also common in those who begin or stop taking birth control or even hormone replacement therapies. It’s also exacerbated by sun exposure, so protecting your skin from harmful UV light is a good starting point. But just because you stop hormonal treatment and steer clear of the sun does not mean melasma will simply vanish. It often sticks around for years after.

What You Can Do About Melasma

So, you have melasma and it’s not going away on its own. What are your treatment options? First of all, there’s not a one-size-fits-all approach to melasma treatment. Everyone is different and there is a lot of tweaking and testing to get it right. Many dermatologists recommend a combination of treatments. Why? Because certain treatments can cause irritation or inflammation, which can make matters worse.

You might be given a compounded topical ointment to start with at home. These can include prescription-grade ingredients like tretinoin, vitamin C, hydroquinone, and kojic acid. While hydroquinone, a bleaching agent, is said to be effective, it’s also controversial. In higher doses, you can only use it for a few months and that’s it. It’s been said to potentially have carcinogenic properties and is banned in Europe. Other promising topical options include niacinamide, alpha-hydroxy acids, and tranexamic acid.

Alternatively, tranexamic acid can also be taken as an oral medication. With short-term usage, it’s shown promising, fast-acting results.

In-Office Treatments for Melasma

If topical treatments for melasma don’t work for you, your dermatologist can provide a variety of in-office treatment options to reduce skin discoloration. Each has its own risks, so it’s best to see a board-certified dermatologist to find out what will work the best for your skin type. These in-office treatments include:

To learn more about your skin’s discoloration or if you suspect you have melasma, schedule an appointment with The Derm Group by calling 973.571.2121.