Melasma is a chronic skin condition that causes discoloration of the facial skin. Melasma usually appears as brown, black, or bluish-gray patches on the upper cheeks, upper lip, forehead, and chin. The main causative factors are hormonal changes and sun exposure so the most effective and long-lasting treatment is to reduce or eliminate the cause. Many women experience melasma during pregnancy, and in this case, the melasma will go away naturally after giving birth.
Method 1 of 3: Get Rid of Melasma with Prescription Medication
Step 1. See your doctor
Talk to your doctor about hormonal changes and creams you can try to get rid of melasma before seeing a dermatologist. Melasma treatment is considered elective and may not be covered by insurance. So, find out the cost of all types of treatments and procedures beforehand.
Step 2. Stop using any medications that may be causing melasma
Certain medications, such as the contraceptive pill and hormone replacement therapy, can affect hormones and trigger melasma. Talk to your doctor about the possibility of stopping this drug.
While pregnancy is the condition most commonly associated with melasma, it is also known to occur due to medications and conditions that affect hormones. After pregnancy, oral contraceptives and hormone replacement therapy are the other two main causes. You can stop using it or replace it with another product to determine if the melasma will fade on its own after that
Step 3. Change your hormone replacement therapy
Usually, hormone replacement therapy cannot be stopped. Consider why you are taking hormone replacement therapy to determine if you can stop or reduce the dose. However, there are ways to change therapy so that the chances of melasma are reduced. Consult your doctor before making any changes.
- Start hormone replacement at night. If you do it in the morning, the sun will shine during the day thereby maximizing the risk of melasma. Changing the schedule to the evening can help alleviate this problem.
- Cream and patch treatments may be less melasma-causing than oral versions of treatments.
- Ask your doctor to give you the lowest possible dose.
Step 4. Ask your doctor for a prescription for hydroquinone cream
While some treatments containing this ingredient can be purchased without a prescription, a dermatologist or GP can prescribe a stronger version that will be more effective at lightening the skin.
- Hydroquinone is available in cream, lotion, gel, or liquid form. Hydroquinone blocks the chemical process in the skin that is responsible for forming melanin because melanin causes dark skin pigment, and the amount of dark pigment associated with melasma can also be reduced.
- Prescription hydroquinone usually has a concentration of 4%. Hydroquinone concentrations higher than 4% are generally not prescribed and are dangerous. High concentrations of hydroquinone can cause ochronosis, which is a permanent discoloration of the skin.
Step 5. Talk to your doctor about secondary skin lightening
Although hydroquinone is used as the first treatment in most cases, a dermatologist may be willing to prescribe a secondary skin lightener to help magnify the effect.
- Tretinoin and corticosteroids are two of the most commonly used secondary treatments. Both can speed up the process of shedding and replacing the body's skin cells. Some dermatologists even prescribe triple creams, which contain tretinoin, corticosteroids, and hydroquinone in one formula.
- Another option is azaleic acid or kojic acid which slows down the production of darkening pigments.
Method 2 of 3: Get Rid of Melasma with Professional Procedures
Step 1. Try a chemical peel
Chemical peels are procedures that use glycolic acid or a similar chemical abrasive to exfoliate the outer layer of skin affected by melasma.
- The skin is smeared with a liquid chemical that causes a mild burning sensation. When the top layer is peeled off, new, melasma-free skin will appear. However, this procedure doesn't prevent melasma if you don't address the hormonal balance that's causing it.
- While glycolic acid is one of the most commonly used options, another common option is trichloroacetic acid, a chemical similar to vinegar. This chemical peel is a bit more painful afterwards, but is a great option for severe cases of melasma.
Step 2. Discuss microdermabrasion and dermabrasion
During this treatment, the top layer of skin is slowly exfoliated and replaced with clean, melasma-free skin.
- Dermabrasion and microdermabrasion are medical procedures that basically exfoliate the surface layer of the skin using an abrasive material. During a dermabrasion procedure, fine crystals are rubbed on the skin. These crystals are abrasive enough to remove dead skin cells and remove melasma-affected skin.
- Usually you can go through about five procedures, each two to four weeks apart. You can also opt for treatment every four to eight weeks if the cause of the melasma has not been treated.
Step 3. Be careful with laser treatments
While some laser treatments can help remove melasma-affected skin, some can actually make it worse. Only undergo laser treatment when performed by a licensed professional. Look for a restorative or minor dual laser treatment that targets only the pigment on the skin's surface.
The cost of small laser treatments tends to be expensive, sometimes reaching 10 million rupiah or more. Remember that you may need three to four treatments over a three to six month period
Step 4. Try treatment with platelet-rich plasma
For this treatment, plasma that has been enriched to promote recovery is injected into the body. This is an experimental recovery, but not yet fully understood. However, preliminary evidence suggests that this plasma may not only treat melasma, but also prevent it from coming back.
Method 3 of 3: Get Rid of Melasma With Home Treatments Without Prescription
Step 1. Protect your skin from the sun
Apply broad-spectrum sunscreen and take other measures to protect skin from the sun. This can prevent the appearance of melasma and reduce the risk of melasma getting worse.
- Apply sunscreen 20 minutes before leaving the house. Look for a sunscreen with an SPF of 30 or more, and consider one additional nutrient, such as zinc, for healthy skin.
- You can also try a “double” sunscreen. Apply an SPF 15 sunscreen under an SPF 30 sunscreen for more protection.
- Wear a wide-brimmed hat and large glasses to protect your face. If your melasma is very severe, you may want to consider a long-sleeved shirt and long pants. Try to avoid direct sunlight as much as possible.
Step 2. Calm down
Stress can exacerbate hormonal imbalances, and if a hormonal imbalance is the cause, reducing stress can help with melasma.
If you're having trouble calming yourself down, try techniques like meditation or yoga. If that doesn't work or doesn't appeal to you, just make time for whatever you enjoy, like taking a walk in the park, reading, or taking a bath
Step 3. Look for an over-the-counter hydroquinone cream
Hydroquinone ointment can lighten the skin and disguise melasma.
- Hydroquinone is available in cream, lotion, gel, or liquid form. Hydroquinone works by blocking the natural chemical process in the skin that is responsible for forming melanin, and because melanin produces dark skin pigment, the amount of pigment associated with melasma will also be reduced.
- There are also hydroquinone creams that contain a small amount of sunscreen so if you want to protect your skin while tackling melasma, this option provides that possibility.
- Over-the-counter hydroquinone creams usually have a concentration of 2% or less.
Step 4. Try a cream containing cysteamine
Because it is naturally present in the cells of the human body, cysteamine is safe and proven to eliminate melasma.
Cysteamine is a natural product of L-cysteine metabolism in the human body. Cysteamine acts as an intrinsic antioxidant and is known to have a protective role against ionizing radiation and as an antimutagen agent. Cysteamine works by inhibiting melanin synthesis to produce depigmentation
Step 5. Use a cream containing kojic acid or melaplex
Both of these ingredients are skin lighteners, but tend to be gentler and less irritating than hydroquinone. These ingredients slow down the production of skin darkening pigments. As a result, new skin cells appear that are less dark and make it difficult for melasma to form.
Step 6. Use tretinoin
Tretinoin is a form of vitamin A that increases the rate at which dead skin cells slough off. Thus, melasma patches fade faster.
However, remember that tretinoin alone does not cure melasma if the cause is not treated. Melasma will shed more quickly, but there is no impact if all skin cells are exposed to melasma
Step 7. Try paper mulberry
This plant is a small tree or shrub, and although it has many non-medical uses, extracts or products containing this plant extract can be used orally or topically to treat melasma, provided you follow the directions for use on the package.
Step 8. Try other holistic treatments
Other ingredients known to help with melasma when applied topically are bearberry, watercress, mandelic acid, lactic acid, lemon peel extract, apple cider vinegar, and vitamin C. All of these ingredients can break down the pigment-producing compounds in the skin without completely removing it and causing irritation. or sensitivity to light.
Step 9. Just wait for it to fade on its own
Melasma that appears due to pregnancy will go away on its own after you give birth. However, it is possible that the melasma will reappear in the next pregnancy.