Melasma is characterized by brown patches of skin that typically appear on the face. More common in women than men, the exact cause remains unknown. Common triggers include pregnancy, birth control pills and medications that increase the skin’s sensitivity to the sun. Many topical treatments can help fade these spots, but you might need to experiment with different treatments before finding the one most effective for you.
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When using topical treatments, you must exercise patience. They can take several months to produce any noticeable improvement, explains the American Academy of Dermatology. Closely following your dermatologist’s directions for treatment will maximize benefits and help produce results sooner than later.
Importance of Sunscreen
When treating melasma, whether with topical medications or other regimens, you must protect your skin from the sun. First, sun exposure weakens the effectiveness of fading creams. Second, many ingredients used to treat melasma can increase your skin’s sensitivity to the sun. Inadequate protection can damage your skin and might even worsen the melasma. The AAD recommends using sunscreens with zinc and titanium dioxide rather than those with chemical protectants. Use one with an SPF of at least 30.
The bleaching agent hydroquinone is one of the most commonly used topical treatments for melasma. Nonprescription treatments contain about 2 percent, but you will probably get better results from prescription versions that offer 4 percent concentrations. Dermatologist Audrey Kunin, writing for her website Dermadoctor.com, explains that the most effective treatments often combine skin-lightening agents like hydroquinone and exfoliating agents like glycolic acid or vitamin A. She also explains that prescription creams containing topical steroids in addition to other ingredients have produced dramatic results. Other topical agents effective for melasma include salicylic acid, kojic acid, vitamin C, licorice extract, azeleic acid and lactic acid.
Kunin explains that kojic acid, a popular ingredient in Asian skin-lightening products, represents a more natural alternative to hydroquinone if you cannot tolerate it or simply want to choose plant-based materials.
Topical treatments for melasma can cause a number of side effects. Hydroquinone in particular can cause spots to actually become darker and give the skin a bluish hue. Kunin notes that these side effects are quite rare though. Steroid-containing creams can produce problems such as thinning of the skin and spider veins. Other ingredients, such as vitamin A derivatives, can dry the skin. You should always use topical treatments for melasma under the supervision of a dermatologist.
While a number of these creams can make a dramatic difference in your melasma, incomplete fading always remains a possibility. You usually need to use the creams on a regular basis to maintain the desired results. Because so many products are available, with various combinations of ingredients, it might take some time to find the treatment that works best for your skin type.