What’s the best treatment for melasma?

Melasma is a common skin condition that causes brown or greyish patches, usually on the face. It is often triggered by hormonal changes, sun exposure, or genetics. While melasma is not harmful, it can be difficult to treat. The best approach depends on the severity of the pigmentation and the patient’s skin type.

What are the most effective treatments for melasma?

Treatment for melasma focuses on reducing pigmentation and preventing it from worsening. The most effective options include:

1. Topical treatments

• Hydroquinone: A skin-lightening agent that reduces melanin production and is often the first-line treatment.
• Retinoids: Help increase cell turnover, improving skin texture and lightening dark patches over time.
• Corticosteroids: Sometimes combined with hydroquinone and retinoids in triple combination creams.
• Azelaic acid: A milder alternative that inhibits pigment production and is safe for sensitive skin.

2. Chemical peels

• Mild chemical peels using glycolic acid, salicylic acid, or trichloroacetic acid (TCA) can help remove pigmented skin cells and promote regeneration.
• These should be performed by a dermatologist to minimise irritation and avoid worsening pigmentation.

3. Laser and light-based therapies

• Laser treatments (such as Q-switched lasers and fractional laser therapy) target pigmentation without damaging surrounding skin.
• Intense pulsed light (IPL) can also be used to break down excess pigment.
• These treatments should be approached with caution, as improper use can lead to increased pigmentation.

4. Sun protection

• Broad-spectrum sunscreen (SPF 50+) is essential for preventing melasma from worsening.
• Wearing wide-brimmed hats and sunglasses provides additional protection.

5. Oral treatments

• Tranexamic acid: A prescription medication that helps reduce pigmentation from within.
• Antioxidants and vitamins: Supplements like vitamin C and glutathione may support skin health.

Can melasma be cured permanently?

Melasma can be managed effectively, but it may not always disappear completely. Long-term maintenance with sun protection and skincare is crucial to prevent recurrence.

The best treatment for melasma varies for each individual. A combination of topical treatments, professional procedures, and strict sun protection offers the most effective results. Consulting a dermatologist is the best way to determine the right approach based on skin type and severity.