Now that the weather is cooling down a bit and beach trips have come to a close, it’s the time of year when we see a lot of melasma in patients. Melasma is hyperpigmented patches aka tan or brown patches usually on the cheeks and above the upper lip, and can also include the lower jawline area or middle of the forehead. Melasma is thought to be caused by sun exposure and hormonal changes. A family history of melasma may also increase your risk.

The treatment of melasma is multi-fold because we feel that not just one cream will fully do the trick. Here are some of our treatment recommendations:

1. Sun protection. You need to use a good sunscreen daily, at least on your face. Some people feel that even sun exposure on other parts of your body when not protected can also contribute to the melasma on your face–Even if your face is covered!! So if you are an avid runner or swimmer, put sunscreen on your body too.
2. Bleaching cream. Using a bleaching cream for a few months can help lighten the dark areas. We recommend using it no more than 3-4 months in a row then taking a one month break before restarting.
3. Retinoids. A retinoid can help decrease the activity of the cells that produce the pigment. They are also anti-aging and reverse sun damage, so we recommend using a small amount of tretinoin (prescription strength version available in our office) or retinol (Revision Retinol Complete, also in our office) for those who are more sensitive. Some patients who are super sensitive or pregnant can use similar medications like azelaic acid.
4. Multi-purpose cleanser. If your life is busy like ours, you want something that has multiple functions so you’re getting your face clean, but also treating sun damage and aging! Our 2 favorites are Glyderm Gentle Cleanser or Revision’s Papaya Enzyme Cleanser. They both have active ingredients that help with dullness by gentle exfoliation without being an abrasive scrub.
5. Peels. Salicylic acid peels are a great option for lightening hyperpigmentation, which we do very often. We recommend at least a series of 3 about 3-4 weeks apart. This type of peel is mild and has little to no downtime. A more aggressive peel, for those that don’t mind 5-7 days of peeling, is the ViPeel. One other option, which we love and has no downtime, is the Silkpeel Dermalinfusion, that uses a lightening peptide that Stanford created called Lumixyl… this is a great option especially around the holidays because it not only helps the brown patches, but makes your skin look hydrated and refreshed! Who doesn’t love that!?

Call or come in for a consultation to discuss any of our recommended products or peels!!

Dana Marshall MD
Ericka Fuoco, Aesthetician