Many treatments can effectively reduce melasma and hyperpigmentation. However, achieving desired results takes time and patience, and many individuals may need to try several methods before finding the one that works best.

The first step is to avoid triggers that can worsen hyperpigmentation, such as sun exposure or hormonal treatments. Once these triggers are managed, you cantry creams and skin-lightening procedures. Common treatment options for melasma include: (1)

• Avoiding triggers, such as birth control pills or hormonal treatments.
• Protection from the sun.
• Skin-lightening creams.
• Skin-lightening procedures, like chemical peels, lasers, and microneedling.
• Tranexamic acid, an oral medication sometimes prescribed for complex cases of melasma.

1- Sun Protection

Sun exposure is a major cause of melasma and hyperpigmentation. No matter how many treatments you try, they won’t be effective without proper sun protection. (1)(2)

• Use a broad-spectrum sunscreen with at least SPF 30 daily.
• Physical sunscreens containing zinc oxide or titanium dioxide are recommended for melasma as they offer stronger protection than chemical sunscreens.
• Apply sunscreen to all exposed areas at least 15-30 minutes before going outside, and reapply every 2 hours and immediately after swimming.
• Wear protective clothing, like hats, long-sleeved shirts, and gloves when possible, and avoid sun exposure between 11 a.m. and 3 p.m.

2- Brightening Creams

• Hydroquinone (HiQuin): Hydroquinone is one of the most effective creams to lighten skin and treat dark spots. However, it should only be usedunder medical supervision as it may cause side effects, such as skin irritation or rebound hyperpigmentation if used excessively or incorrectly. (1)
• The Triple Therapy (Acretin - HiQuin - AlphaCort): This is the most effective formulation to treat melasma. (3)
  • It combines an exfoliant (Acretin), a bleaching agent (Hydroquinone), and a mild corticosteroid (Alphacort),making it highly effective in treating hyperpigmentation and melasma.
  • It shows excellent results in reducing melasma and severehyperpigmentation. However, it should be used cautiously and only undermedical supervision for a limited time to avoid potential side effects.
  • These ingredients are also available in single creams like Trioliteand Triderma.‍
• ‍Safe Skin lightening Creams: For mild to moderate pigmentation, safer alternatives include creams with ingredients like: (3)
• Arbutin.
• Azelaic acid.
• Kojic acid.
• Vitamin C.
• Methimazole.
• Cysteamine.
• Glutathione.
• Soybean extract.

Consulta dermatologist before starting any skin-lightening cream to avoid potential side effects such as irritation and sensitivity.

3- Skin Lightening Procedures

For stubborn pigmentation, additional procedures may be added, including: (2)

• Chemical Peels: This popular treatment involves applying a chemical solution that exfoliates the skin, helping to lighten pigmentation. Common acids used include glycolic and salicylic acid.
• Laser Treatments: Lasers target pigmentation by sending concentrated light pulses that destroy excess pigment cells, resulting in lightening dark spots.
• Microneedling: Using tiny needles, this technique boosts collagen production and enhances the penetration of lightening creams into deeper skin layers.
• Platelet-Rich Plasma (PRP): This involves extracting plasma from your blood and injecting it into melasma spots, helping even out skin tone.

Warning

All of these treatments are effective but require precision and expertise If performedincorrectly or by non-specialists, they can lead to adverse effects such as worsening pigmentation, skin inflammation, or scarring.

4- Tranexamic Acid

Originally used to treat bleeding disorders, tranexamic acid can also help in lightening melasma when other treatments are ineffective. (2)

It can be administered orally, topically, or injected directly into the skin (Mesotherapy). (2)

Tranexamic acid is usually taken as oral pillsin conjunction with the triple cream but should only be used under a doctor’s supervision, especially for those with blood clotting issues. (2)

When to Expect Results?

Treating melasma and pigmentation requires patience and commitment, as results can take anywhere from 3 months to a year to become noticeable. Consistent treatment typically leads to gradual improvement. (2)

Dermatologists at Dr. Soliman Fakeeh Hospital bring extensive expertise in selecting the most suitable procedures for your skin, ensuring optimal results with maximum safety. 

References

1. British Association of Dermatologists - Melasma
2. American Academy of Dermatology Association - Melasma: Diagnosis and treatment
3. DermNet - Melasma