Table of ContentsView AllTable of ContentsTriggersOTC TherapiesHome RemediesMedicationsProceduresTips During PregnancyDoes Treatment Work?Frequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Triggers
OTC Therapies
Home Remedies
Medications
Procedures
Tips During Pregnancy
Does Treatment Work?
Frequently Asked Questions
Melasmatreatments include over-the-counter skincare products that brighten or exfoliate and prescription medications such as topical hydroquinone. It is important to remember, however, that melasma, a condition that causes dark or uneven patches on the face and other areas of the skin, isn’t harmful. Thus, there’s no medical reason to treat it unless it bothers you.
If you do choose to treat your melasma, it can be a slow and difficult process. Avoiding triggers is usually the best way to deal with the condition.
This article discusses melasma treatment at home, prescription medications, and other therapies that can help fade melasma hyperpigmentation.
Verywell / Nusha Ashjaee
Avoiding Triggers
The best way to control melasma is to avoid the things that trigger it. This may mean wearing sunblock and/or discontinuing the use of certain medications or skincare products. Some of the things that can trigger melasma include:
Sun Exposure
Protecting your skin from the sun is incredibly important. Sun exposure is a chief trigger factor for melasma development.
Regardless of the treatment you use, if you don’t protect your skin from the sun, you will not see a great improvement in your melasma.
If you’re not already using a daily sunscreen product, now is the time to start.Choose a sunscreenwithSPFof 30 or higher, and apply it daily. Ideally, you should wear sunscreen 365 days a year, even on cloudy, rainy, or cold days, and even if you don’t spend much time outdoors. Just a small amount of sun exposure can darken your melasma.
For those days when you are spending a lot of time outside, reapply sunscreen frequently. Also, consider wearing a hat or spending as much time as possible in the shade.
This photo contains content that some people may find graphic or disturbing.See PhotoDermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Even after treatment works and melasma has faded, you’ll need to continue strict sun protection. It is possible for your melasma to completely return after just a few hours in the sun.
To help your skin respond to other forms of treatment you may be using, use sunscreen as part of your daily skincare routine. An added benefit is that you’ll also be protecting your skin fromphotoagingandskin cancer.
Birth Control
Because melasma is related to fluctuations in hormones, it can occur when you start or stop taking hormonal birth control pills. Some people may also develop melasma after they start or stop hormone replacement therapy.
Products That Irritate Skin
Skincare products that irritate your skin may make your melasma worse. Avoid scented soaps and other products with fragrances. Retinoids and other skincare products that cause increased sun sensitivity may also worsen your melasma.
Other Factors
Risk Factors
Certain people may be more prone to developing melasma. These include:
Over-the-Counter Treatments
Over-the-counter skincare products and cosmeceuticals that contain brightening or exfoliating ingredients can be of some help if your melasma is minor. You can add these to your daily skincare routine, but be prepared for a wait. Melasma takes a long time to fade; you won’t see improvement for several months.
Some helpful ingredients to look for:
Do Home Remedies Help?
In general, home remedies aren’t incredibly effective at improving melasma. A few alternative remedies, liketurmericandaloe vera, have shown at least some success at improving melasma.However, there’s not enough info to recommend aloe or turmeric as melasma treatments, and conventional treatments work faster and have better results.
Other home remedies may actually make melasma worse. Don’t apply things likelemon juice,apple cider vinegar, raw onion, or garlic to your skin. These highly acidic ingredients can irritate your skin, which can lead to darkening of the very spots you’re trying to lighten. Lemon also is aphotosensitizer, so it makes your skin much more susceptible to sun damage.
Prescription Medications
The darker the melasma is in comparison toyour normal skin tone, the more difficult it is to treat. In this case, prescription medication is going to give you better results than OTC options.
Hydroquinone
This is a controversial ingredient though, as some question its safety citing potential carcinogenic effects. Other studies have found no link between hydroquinone and cancer in human beings. High-percentage hydroquinone products can cause permanent loss of skin color (hypopigmentation) and in rare cases, darkening and thickening of the skin (ochronosis).
This controversy has led some countries to ban hydroquinone when used as askin-bleachingagent (although it still can be used in lower percentages in other cosmetic products). The United States Food and Drug Administration briefly considered banning the ingredient in 2006.
The general consensus among dermatologists is that hydroquinone is safe when used appropriately, although you should know that there are some dermatologists who disagree. The ingredient is usually very effective, which is why some people may risk the side effects to use it.
If your dermatologist prescribes hydroquinone to treat your melasma, make sure you use it as directed and don’t be afraid to ask questions about your treatment.
Make sure to discuss any potential side effects you experience if you are using hydroquinone and to never use this substance outside of a healthcare provider’s supervision.
Topical Corticosteroids
Topical corticosteroids, also known as steroid creams, are prescribed for many skin issues because they’re anti-inflammatory. They also have mild skin lightening effects. For melasma, topical corticosteroids aren’t very effective on their own so you’ll also be prescribed another topical treatment to be used along with them.
Tretinoin
However, tretinoin is effective when used long-term as a maintenance cream.
Triple Combination Cream
Sold as the brand Tri-Luma, this medication is a blend of tretinoin, corticosteroid, and hydroquinone. It gives you the benefits of the aforementioned medications in one cream. This treatment does work faster than using any one treatment alone, and it can improve even severe melasma.
The drawback of a triple combination cream is that it is more likely to cause skin irritation and it can’t be used long-term to keep melasma away.
Azelaic Acid
Azelaic acid is another skin lightening agent. Like tretinoin, azelaic acid speeds up cell turnover and smooths the skin. It evens out your skin tone, is fairly gentle, and can be used long term. It is often used as an alternative to hydroquinone.
Tranexamic Acid
This drug is not used as often to treat melasma but is becoming more common. Tranexamic acid is an oral medication that inhibits melanin production. It’s not an approved melasma treatment and is used off-label. It’s not recommended as a first-line treatment for melasma, but may be prescribed in certain situations when other treatments aren’t working.
There are also in-office procedures that your dermatologist can do to treat melasma. These are good options if topical treatments aren’t well working for you, if your melasma is moderate to severe, or if you simply want a jump-start to treatment.
Most professional procedures should be used as an add-on treatment, and not necessarily a solo treatment, for melasma.
Your dermatologist will let you know if any of these procedures are a good treatment choice for you:
Treatment Tips During Pregnancy
Formelasma that develops during pregnancy,there is some good news. This type of melasma often fades away, with some completely disappearing within a year or so after giving birth. Even if it doesn’t disappear, it generally fades considerably.
If you’re currently pregnant, your healthcare provider will likely take a wait-and-see approach before trying any type of treatment. Many of the medications used to treat melasma are not safe to use during pregnancy.
Do Melasma Treatments Really Work?
Treatment for melasma can be challenging. Fading of hyperpigmentation takes a long time and may not be complete. There can be some trial and error involved in finding a treatment that works for you, and it’s fairly common for the pigmentation to return even after treatment.
In some cases, it’s more realistic to think more in terms of lightening and fading the discolorations rather than completely erasing them. With consistent, long-term use of treatment, it is possible to achieve considerable improvement of melasma.
Even without treatment, melasma will often fade over time, especially if you take care to avoid triggers such as sunlight. It is also possible for the condition to resolve on its own or to be unusually responsive to treatment. Sometimes, however, melasma is a permanent condition.
Types of Cosmetic Laser Procedures
Summary
Melasma is difficult to treat and may take a long time to clear up. Certain medications and treatments can help fade melasma, and in some cases it may evenutally disappear on its own.
Frequently Asked QuestionsThere is no one best way to cure melasma. Most dermatologists treat melasma with a multi-pronged approach of sun protection andtopical treatments. In some cases, just avoiding the sun may be enough for hyperpigmentation to resolve.Possibly. Melasma hyperpigmentation may go away with treatment, however, it can come back again if you spend time in the sun. You will need to continue to use sunscreen to prevent melasma from returning.It depends. Melasma hyperpigmentation from pregnancy usually resolves on its own within a year or so after giving birth. Other causes of melasma take between three months and a year of professional treatment to resolve. If the hyperpigmentation has been around for a long time, it may take even longer to clear up.
There is no one best way to cure melasma. Most dermatologists treat melasma with a multi-pronged approach of sun protection andtopical treatments. In some cases, just avoiding the sun may be enough for hyperpigmentation to resolve.
Possibly. Melasma hyperpigmentation may go away with treatment, however, it can come back again if you spend time in the sun. You will need to continue to use sunscreen to prevent melasma from returning.
It depends. Melasma hyperpigmentation from pregnancy usually resolves on its own within a year or so after giving birth. Other causes of melasma take between three months and a year of professional treatment to resolve. If the hyperpigmentation has been around for a long time, it may take even longer to clear up.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Passeron T, Picardo M.Melasma, a photoaging disorder.Pigment Cell Melanoma Res.2018;31(4):461-465. doi:10.1111/pcmr.12684Hoque F, McGrath J, Shaude SE.Melasma (chloasma): Pathogenesis and treatment.J Biotechnol Biomed. 2022;5:236-43. doi:10.26502/jbb.2642-91280064American Academy of Dermatology.Melasma: Causes.Harvard Health Publishing.Unmasking the causes and treatments of melasma.Hollinger JC, Angra K, Halder RM.Are natural ingredients effective in the management of hyperpigmentation? A systematic review.J Clin Aesthet Dermatol. 2018;11(2):28-37.Ogbechie-Godec OA, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb).2017;7(3):305-318. doi:10.1007/s13555-017-0194-1American Society for Dermatologic Surgery Association.Position on topical hydroquinone.Kim HJ, Moon SH, Cho SH, Lee JD, Kim HS.Efficacy and safety of tranexamic acid in melasma: A meta-analysis and systematic review.Acta Derm Venereol.2017;97(7):776-781. doi:10.2340/00015555-2668American Academy of Dermatology Association.Melasma: Diagnosis and treatment.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Passeron T, Picardo M.Melasma, a photoaging disorder.Pigment Cell Melanoma Res.2018;31(4):461-465. doi:10.1111/pcmr.12684Hoque F, McGrath J, Shaude SE.Melasma (chloasma): Pathogenesis and treatment.J Biotechnol Biomed. 2022;5:236-43. doi:10.26502/jbb.2642-91280064American Academy of Dermatology.Melasma: Causes.Harvard Health Publishing.Unmasking the causes and treatments of melasma.Hollinger JC, Angra K, Halder RM.Are natural ingredients effective in the management of hyperpigmentation? A systematic review.J Clin Aesthet Dermatol. 2018;11(2):28-37.Ogbechie-Godec OA, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb).2017;7(3):305-318. doi:10.1007/s13555-017-0194-1American Society for Dermatologic Surgery Association.Position on topical hydroquinone.Kim HJ, Moon SH, Cho SH, Lee JD, Kim HS.Efficacy and safety of tranexamic acid in melasma: A meta-analysis and systematic review.Acta Derm Venereol.2017;97(7):776-781. doi:10.2340/00015555-2668American Academy of Dermatology Association.Melasma: Diagnosis and treatment.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Passeron T, Picardo M.Melasma, a photoaging disorder.Pigment Cell Melanoma Res.2018;31(4):461-465. doi:10.1111/pcmr.12684Hoque F, McGrath J, Shaude SE.Melasma (chloasma): Pathogenesis and treatment.J Biotechnol Biomed. 2022;5:236-43. doi:10.26502/jbb.2642-91280064American Academy of Dermatology.Melasma: Causes.Harvard Health Publishing.Unmasking the causes and treatments of melasma.Hollinger JC, Angra K, Halder RM.Are natural ingredients effective in the management of hyperpigmentation? A systematic review.J Clin Aesthet Dermatol. 2018;11(2):28-37.Ogbechie-Godec OA, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb).2017;7(3):305-318. doi:10.1007/s13555-017-0194-1American Society for Dermatologic Surgery Association.Position on topical hydroquinone.Kim HJ, Moon SH, Cho SH, Lee JD, Kim HS.Efficacy and safety of tranexamic acid in melasma: A meta-analysis and systematic review.Acta Derm Venereol.2017;97(7):776-781. doi:10.2340/00015555-2668American Academy of Dermatology Association.Melasma: Diagnosis and treatment.
Passeron T, Picardo M.Melasma, a photoaging disorder.Pigment Cell Melanoma Res.2018;31(4):461-465. doi:10.1111/pcmr.12684
Hoque F, McGrath J, Shaude SE.Melasma (chloasma): Pathogenesis and treatment.J Biotechnol Biomed. 2022;5:236-43. doi:10.26502/jbb.2642-91280064
American Academy of Dermatology.Melasma: Causes.
Harvard Health Publishing.Unmasking the causes and treatments of melasma.
Hollinger JC, Angra K, Halder RM.Are natural ingredients effective in the management of hyperpigmentation? A systematic review.J Clin Aesthet Dermatol. 2018;11(2):28-37.
Ogbechie-Godec OA, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb).2017;7(3):305-318. doi:10.1007/s13555-017-0194-1
American Society for Dermatologic Surgery Association.Position on topical hydroquinone.
Kim HJ, Moon SH, Cho SH, Lee JD, Kim HS.Efficacy and safety of tranexamic acid in melasma: A meta-analysis and systematic review.Acta Derm Venereol.2017;97(7):776-781. doi:10.2340/00015555-2668
American Academy of Dermatology Association.Melasma: Diagnosis and treatment.
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