Melasma- Erasing the Summer Sun« Back
The cornerstone of treatment is sun/light protection. Broad spectrum sunscreens containing a physical blocker such as zinc or titanium dioxide should be worn everyday, regardless of the weather, time spent outside or other factors. Recently, sunscreen containing iron oxide has been shown to help, as Melasma can be worsened with exposure to visible and infrared (heat) light. When outdoors, hats should be worn and direct sun exposure should be avoided. Dietary supplements containing antioxidants can also help prevent sun exposure and help with sun sensitive conditions. Heliocare is an example, it is an extract of a fern and is taken as an oral supplement prior to sun exposure.
Bleaching creams containing hydroquinone are also effective. They should be used twice daily until improvement (usually 4-6 weeks) and then decreased to once daily. Often they will need to used through the summer to prevent rebound. Hydroquinone is often mixed with other medications to improve efficacy and decrease irritation. Common added ingredients are Kojic acid, tretinoin and a mild steroid. Cascade Eye and Skin Centers carries a 6% hydroquinone compound, but stronger compounds can be special ordered if needed.
Other lightening creams such as Lytera from SkinMedica are useful for mild cases and maintenance once hyperpigmentation resolves, Vitamin C and soy containing creams are natural skin lighteners but not as strong as hydroquinone.
For resistant/severe cases, an oral medication called tranexaminic acid can be prescribed for treatment. Tranexaminic acid is used for other disorders that cause excessive bleeding such as heavy menstrual cycles or nose bleeds. It helps by decreasing the vascular component of Melasma. It should not be used in anyone with a personal or family history of clotting disorders or anyone trying to get pregnant. It is not FDA approved for this condition, but is generally a safe medication. Common side effects are nausea. The dose is 1/2 pill twice a day and is usually taken for 3 months. This medication requires a consultation with one of our cosmetic providers.
SkinMedica Total Defense and Repair Suncreen
Colorscience Even-Up - Protects against UVA/UVB/Visible and infrared light
CascadeEye & Skin Centers Melasma Emulsion Cream: Hydroquinone 6%, Kojic Acid, Tretinoin
Cascade Eye & Skin Centers Melasma Procedure Cream: Hydroquinone 6%
Recommended Procedures to speed clearance (in conjunction with topical products):
Clear and Brilliant