How to Get Rid of Melasma: Treatments, Skincare, and Prevention

If you’ve been struggling with melasma, this guide will walk you through what causes it, how to treat it, and what steps you can take to prevent it from coming back.

What is Melasma, and What Triggers It?

Melasma appears as brown or grayish patches on the skin, most commonly on the cheeks, forehead, upper lip, and jawline. It occurs due to an overproduction of melanin (the pigment that gives your skin its color). Unlike typical dark spots, melasma is often triggered by internal and external factors, making it more complex to treat.

Common Triggers of Melasma

• Hormonal Changes: Pregnancy, birth control, and hormone therapy can stimulate melanin production, leading to melasma. This is why it’s sometimes referred to as the “pregnancy mask.”
• Sun Exposure: UV rays activate melanocytes (pigment-producing cells), darkening existing melasma and triggering new patches.
• Heat and Inflammation: Exposure to high temperatures, even without direct sun, can worsen melasma. Activities like hot yoga or excessive exfoliation can contribute.
• Genetics: If melasma runs in your family, you may be more prone to developing it.

Professional and Prescription Treatments for Melasma

1. Prescription-strength Topicals

• Hydroquinone: A skin-lightening agent that helps reduce melanin production and fade dark patches. Often prescribed for short-term use.
• Tretinoin (Retinoid): Helps increase cell turnover to gradually lighten pigmentation over time.
• Azelaic Acid: A gentler alternative to hydroquinone that reduces pigmentation while also calming inflammation.
• Cysteamine Cream: A newer topical treatment that helps reduce the appearance of dark spots with fewer side effects than hydroquinone.

2. In-office Procedures

• Chemical Peels: Medium-depth peels with ingredients like glycolic acid or trichloroacetic acid (TCA) can help exfoliate and lighten dark patches.
• Laser Therapy: Some lasers can be used cautiously to break up pigment, but not all lasers are safe for melasma. Our dermatology providers will determine the best option based on your skin type.
• Microneedling with Tranexamic Acid: A promising treatment that helps deliver pigment-reducing ingredients deeper into the skin.

• Mineral-based formulas with zinc oxide or titanium dioxide
• Tinted sunscreen with iron oxides to protect against visible light (which can also darken melasma)
• Water-resistant sunscreen if you spend time outdoors or sweat frequently

• Vitamin C is a powerful antioxidant that prevents pigmentation and brightens the skin.
• Niacinamide helps regulate melanin production and reduces inflammation.
• Tranexamic Acid is an emerging ingredient that helps fade melasma and prevent recurrence.

• Mild chemical exfoliants like glycolic acid or lactic acid can help promote cell turnover.
• Enzyme-based exfoliators (like papaya or pumpkin enzymes) offer a gentler alternative.
• Our Lactic/Mandelic/Salicylic Exfoliating Pads are one of the top-selling products at our practice. They harness the peeling power of three powerful acids to sweep away dead skin cells and reveal a bright, healthy and youthful glow.

• Hyaluronic acid to provide deep hydration without clogging pores.
• Ceramides to strengthen the skin’s protective barrier.
• Licorice root extract to help brighten dark spots while soothing the skin.

• Colorescience Even Up Multi-Correction Serum: A lightweight serum that brightens skin tone, reduces discoloration and defends against environmental stressors.
• Colorescience Even Up Clinical Pigment Perfector SPF 50: A tinted mineral sunscreen that provides sun protection while correcting and preventing hyperpigmentation.
• SkinMedica Even & Correct Advanced Brightening Treatment: A non-hydroquinone formula that visibly fades dark spots and evens out skin tone with powerful brightening ingredients.
• Heliocare Advanced with Nicotinamide: While not a serum or moisturizer, an oral supplement like Heliocare may benefit patients looking to fight melasma. Heliocare helps support skin health and maintain the skin’s ability to protect against free radicals, promoting more resilient, younger-looking skin.*

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.