Our expert says:
Hi Vigie, thank you for the question.
Melasma is a difficult condition to treat however the cornerstone of its treatment is a SPF 30 or higher that must contain zinc oxide and titanium dioxide applied several times daily and the use of sun avoidance (such as the use of a hat or umbrella with extended sun exposure - more than 5 minutes).
My advice would be to add a topical regime that includes the hydroquinone with the NeoStrata Pigment Lightening Gel (at night) and the Brightening Cream SPF 15 (during the day). I would also consider the use of topical retinoids or its derivatives (vitamin A) such as NeoStrata Renewal Cream.
Following the above regime the treatment recommendations become less clear cut and the following treatment options are all viable options:
Adding NeoStrata Glycolic acid peels with depigmenting booster pads 10 days prior to the Fraxel procedure
Using cold masks or ice for 15 minutes after the Fraxel treatments to reduce inflammatory reactions as much as possible
Some dermatologists in the US are recommending triple therapy regimes that consist of IPL (15 minutes of icing) followed by non ablative low intensity fractional resurfacing (15 minutes of icing) followed by a Jessner’s solution (mild frosting) and TCA peel (early frosting).
Ultimately you need to consider that the Melasma may only be lightened and that without sun avoidance, a good topical SPF, and an ongoing daily topical regime as described above, the Melasma may return in the future. Further considerations is changing one’s contraceptive and assessing blood hormone levels with your gynecologist and adding Heliocare Tablets to improve the skin’s natural sun protective mechanism.
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