How to Treat Melasma Once and For All, According to Dermatologists

Woman looking in mirror while cupping her face.

Willie B. Thomas / Getty Images

Melasma—maybe you’ve heard of it. Or perhaps you’re scratching your head wondering what on Earth it is. Which, to be honest, makes sense, considering it’s more commonly referred to as dark spots on your face. Now that we have your undivided attention, let’s dive in. 

What Is Melasma?

According to cosmetic dermatologist Michele Green, MD, melasma is a skin condition that causes patches of dark discoloration on the skin. “It usually occurs on the face, predominantly on the cheeks and forehead,” she explains, noting that it’s usually caused by hormonal changes and/or sun exposure.

While there are no known health risks associated with melasma, Green acknowledges that the uneven color has been known to lead to self-consciousness. Since we believe that everyone should be empowered to feel their most confident, we’ve rounded up a handful of ways to make melasma a skin concern of the past. While melasma is in no way something that needs to be addressed, we’re here to help you do so if you want to.

Meet the Expert

  • Michele Green, MD is a board-certified cosmetic dermatologist based in the Upper East Side of NYC. She has been recognized by New York Magazine and Castle Connolly as one of the Best Doctors in New York. 
  • Kerry Benjamin is a licensed aesthetician and founder/CEO of StackedSkincare.
  • Marisa Garshick, MD, FAAD is a board-certified dermatologist in New York. She is also an assistant clinical professor of dermatology at Cornell - New York Presbyterian Medical Center. 

While both men and women live with melasma, Green says that women are more often affected, as hormonal changes during pregnancy or while taking birth control are triggers.

How Long Until Melasma Goes Away?

Melasma is a skin condition that can be diminished, but there’s not an actual cure for it. Because of this, Green reminds us that melasma can reoccur post-treatment, especially if you don’t make the treatments a regular part of your routine, or if repeated sun exposure is part of your day-to-day. But don’t let that discourage you.

Green says that there are effective melasma treatments that work and offer long-lasting results. Check them out, below.

01 of 10

Try Cosmelan Peels to Reduce Facial Melasma

Cosmelan is a two-part process that includes two chemical peels spaced three weeks apart. “In my office, I do Cosmelan peels to reduce facial melasma,” Green says. “The great thing about the Cosmelan treatment is that it is safe and effective for all skin types."

These peels are especially popular for the treatment of melasma because they're not formulated with hydroquinone, a popular melasma treatment that may, in some cases, cause redness and/or dryness.

02 of 10

Incorporate Exfoliation into Your Daily Routine

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It's no secret exfoliation is key for smoothing skin and minimizing dark spots—which just so happens to include melasma. “Peels rich in trichloroacetic (TCA) acid and lactic acid like our TCA Multi-Acid Face Peel evenly exfoliate the outermost layer of the skin, which can aid in breaking apart pigmented cells,” Benjamin says.

03 of 10

Ramp Up Your Retinol and Retin-A Use

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Green tells us that retinol and Retin-A turn over the skin cells, rejuvenate the skin, and produce new collagen as well. Depending on your level of melasma, you may be able to get away with OTC retinol, but if you have stubborn dark spots, you may want to consult your dermatologist for a prescription dose of Retin-A.

04 of 10

Try Dermaplaning to Lift Dark Spots

Another way to diminish the appearance of melasma? Dermaplaning, of course. "Peels and dermaplaning are the perfect exfoliation partners because where peels speed up cell turnover, which causes old cells to shed and flake off, dermaplaning helps slough off these dead cells more effectively, which gradually removes some of the superficial hyperpigmentation and reveals a more even skin tone," says Benjamin.

05 of 10

Consider How Your Contraceptive Might Play a Role

Because melasma has been linked to hormonal changes and imbalances, it's possible that birth control can play a role in exacerbating your melasma. If you use hormonal birth control, consult your physician or a dermatologist about how your prescription might be making your melasma worse, and if there is a different contraceptive that might be better suited for you.

06 of 10

Stock Your Skincare Routine With Vitamin C

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Since the discoloration of melasma stems from an overproduction of melanin, Green says that you need to use products that will reduce this pigmentation and treat the excess melanin. “Vitamin C serum works as an antioxidant to lighten up dark spots and rejuvenate skin," she points out.

Garshick adds to this, noting that vitamin C will fight free radical damage and brighten the skin overall. “One particular vitamin C product good for those with melasma is the Revision C Correcting Complex, which contains a combination of Vitamin C with patent-pending MELA-path technology to help provide protection against free-radical damage from blue light, so helps to brighten and improve skin tone," she says.

07 of 10

Use Products That Help Speed Up Cell Turnover

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Another great way to reduce the appearance of melasma is by stimulating cell turnover, which will help to gradually replace pigmented cells: “Our EGF Activating Serum contains natural epidermal growth factors that stimulate the skin’s ability to regenerate and heal, gradually brightening and lifting hyperpigmentation over time,” Benjamin says.

For even better results, she says to pair a turnover-boosting serum with microneedling to help the serum sink even deeper into the skin to target far-reaching melasma. 

08 of 10

Make Room for Hydroquinones in Your Routine

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According to Green, products containing hydroquinones decrease pigmentation.

Garshick expands on this, noting that hydroquinone is a well-known lightening cream that has been used for the treatment of melasma for many years with different concentrations available (it used to be available over the counter, but is now only available with a prescription). “While it is an effective treatment for melasma, it should always be done under the direction and supervision of a board-certified dermatologist, given the potential risk of ochronosis or paradoxical darkening that can be associated with it,” she emphasizes.

09 of 10

Apply Sunscreen Every Single Day—No Matter What

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Benjamin says that sun exposure can make melasma worse, which means SPF is a must. And, folks, this includes days when you’re not spending a lot of time outside, as well as days where it’s incredibly cloudy outside. After all, UV rays can still shine through.

When it comes to sunscreen, Garshick recommends broad-spectrum (UVA and UVB coverage), physical blockers that are zinc or titanium-based, and that IS SPF 30 or higher. “Additionally, there are some studies that suggest that those with hyperpigmentation or melasma may be more susceptible to worsening discoloration from high energy visible light or blue light,” she adds. “For this reason, it is also recommended to have protection against blue light, so it is good to look for sunscreens that offer protection against this such as iron-oxide containing sunscreens such as Elta MD UV Elements Tinted. I like this sunscreen as not only does it provide broad coverage but it also is easy to apply for daily use.”

10 of 10

Consult a Dermatologist to Guide Your Melasma Journey

Sometimes it’s best to speak with a board-certified dermatologist to determine the best treatment for your melasma concerns. There are prescriptions such as Triluma, which contains a combination of hydroquinone, a retinoid, and steroid for the treatment of melasma,” Garshick shares.

Additionally, since melasma can be particularly sensitive to worsening hyperpigmentation, Garshick says that it is important to make sure to check with a board-certified dermatologist before doing any specific laser or treatment.

When to See a Professional

Although there are various treatments that help improve melasma and many people do find success with them, Garshick tells us that melasma is a skin condition that can come and go with the seasons and varying levels of estrogen. What’s more, while it’s largely not something to worry about in the grander scheme of health, Green says that the appearance of melasma can be an indication of underlying health conditions such as thyroid disease or other endocrine problems. Because of this, if the treatments above don’t seem to do you any good, you should seek out a derm’s professional opinion on what’s going on with your skin and health as a whole. 

FAQ
  • Should the IPL laser be used for melasma?

    IPL or intense-pulsed light laser is not the best choice for treating melasma because it can heat the surrounding skin—which can actually cause an increase in melasma for some. In addition, for those that it does help, the results of IPL are short term with the melasma often quickly reappearing.

  • Is it true that computer screens make melasma worse?

    Computer screens, phones, laptops, and TV screens can all emit blue light, which can make melasma worse. Look for blue-light blocking skincare products to wear daily to help prevent this.

  • What causes a dark upper lip?

    The same factors that cause melasma or dark spots on your cheeks and forehead are also responsible for a dark upper lip, also called a “melasma mustache" or "sun mustache." These factors include sun exposure, hormones, and genetics. Follow the tips outlined above to see improvement.

  • How do you use makeup to cover melasma?

    To conceal brown spots, look for peach-toned products over beige tones. You may want to visit a beauty counter to help find the right color. Use a full-coverage foundation (versus sheer or lighter formulas) and apply with a stippling brush, followed by a setting powder. 

  • Can you reverse melasma naturally?

    Turmeric, aloe, papaya, almond oil, and yogurt can be applied topically on the skin to fade dark spots naturally, however, the results may not happen as quickly or as consistently as formulated products.

Article Sources
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  2. Shankar K, Godse K, Aurangabadkar S, et al. Evidence-based treatment for melasma: expert opinion and a review. Dermatol Ther (Heidelb). 2014;4(2):165-186.

  3. Sahu P, Dayal S. Most worthwhile superficial chemical peel for melasma of skin of color: Authors’ experience of glycolic, trichloroacetic acid, and lactic peel. Dermatol Ther. 2021;34(1):e14693.

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  6. De Dormael R, Bastien P, Sextius P, et al. Vitamin c prevents ultraviolet-induced pigmentation in healthy volunteers: bayesian meta-analysis results from 31 randomized controlled versus vehicle clinical studies. J Clin Aesthet Dermatol. 2019;12(2):E53-E59.

  7. 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.

  8. Lutfi RJ, Fridmanis M, Misiunas AL, et al. Association of melasma with thyroid autoimmunity and other thyroidal abnormalities and their relationship to the origin of the melasma. J Clin Endocrinol Metab. 1985;61(1):28-31.

  9. Mayo Clinic. Mayo Clinic Q and A: Treating Melasma. November 2019. 

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