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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4069
Experience:  30 years practice in general and cosmetic dermatology
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I suffer from melasma due to sun exposure while using obagi

Customer Question

hi, I suffer from melasma due to sun exposure while using obagi nuderm 4 years ago. I tried pigmanorm for 8 months but it didn't work. I had tried a medium depth peel in London last year which made improvement but i may not have been very careful with the sun protection so majority came back after 6 months. It recently got worse due to using over the counter 1% retinol cream which created inflammation and spread the melasma bit more.
i am just had dermamelan treatment 2 days ago but i don't think my melasma would improve much since i had it for long time now. would it help with the new pigment you reckon?
i plan to start using my derm's recommendation i.e. tretonin 0.5% at night and vitamin c serum after about 3 months as i know dermamelan effect will be temporary so I would use my derm's protocol of monthly jessner's peel along with topical products.
can you give me an honest answer? would my melasma ever diminish so that i don't have to weak much makeup? or is it likely to s
Submitted: 1 year ago.
Category: Dermatology
Expert:  khagihara replied 1 year ago.

Try a triple combination cream containing hydroquinone 4%, tretinoin 0.05%, and fluocinolone acetonide 0.01% as first-line therapy for patients with melasma. The cream is applied twice a day for 8 to 24 weeks and up to 12 months. With refractory melasma, chemical peels or laser and light-based therapies may be used in conjunction with skin lightening agents. However, these treatments should be used with extreme caution in patients with darker skin types who have an increased risk of postinflammatory hyperpigmentation.