Hello,
Just wanted to share my melasma regimen as it has helped clear a good deal of my epidermal melasma.
My melasma covers my forehead, a portion of both cheeks and my upper lip ( sadly the dermal kind). I've been living with it for nearly three years and have dedicated the last two years to combating it in earnest.
The products that have proven most effective for me are:
1. Retin-a (0.05)
2. Azeliac Acid (not Skinoren as it contains Phenol and has a six month useage limit)
3. Monthly chemical peels (rotating between Jessner, Glycolic 30%, Salicylic Acid 15%)
4. LOTS of sunscreen with titanium and zinc oxide ALL the time.
I have found that the Retin-a helps the Azeliac Acid penetrate more deeply and as such my melasma is NOT fading in areas but completely gone. I know that Azeliac suppresses the function which results in overproduction of melanin however it is clearly doing something additional which may include repairing the damage that resulted in the melasma. Or maybe the two products happen to compliment each other but all I can say is it is working. Moreover, I want to stress that the areas that are clearing no longer react ( turn dark) when they are exposed to sunlight. I know that Tri Luma users state that once they discontinue using it the melasma comes back which means it was never really gone only lighter, this is NOT what is happening with me.
The most challenging area has been the upper lip / dermal melasma however it too has lightened considerably. Those of you who live with the dreaded upper lip melasma know what happens when you spend too much time in the sun or god forbid sweat a little. THIS has greatly decreased and now it is FAR easier to cover with simple makeup, not thick concealer and neutralizer.
The chemical peels also help A LOT! The peel removes a superficial layer of skin each time thus allowing the medication to penetrate deeper. I also deal with acne and oily skin hence the peels help keep this under control. And despite having melasma, the treatments have improved the texture of my skin so overall my skin appears healthier and more vibrant.
Speaking of skin texture, I have noticed a marked difference between my healthy skin texture and the melasma affected areas. The melasma areas are raised and course - damaged unlike anything I have ever seen on my skin in years past.
I apply Retin-a and AA together but every other night, I moisturize deeply on the off days. I believe this has helped me deal with the redness and peeling so often mentioned with both Retin-a and AA.
Overall, my melasma is now at a point where I can apply sunscreen and dust my face with a little pigmented powder and it is not noticeable.
I can not stress enough how important it is to pick a treatment and stick with it for at least ONE YEAR. It took this long before I began to see any discernible changes and believe me I came close to giving up.
Sadly, to date their is no "cure" or quick fix that I know of and believe me I spend a lot of time trying to find it.
Hopefully I can help someone out there which is why I am sharing. I have found dermatologists to be of little help when it comes to this, especially since I am Fitzpatrick skin type 4. Hydroquinone and other lightening products and generally prescribed treatments can cause more problems for dark skinned individuals so caution is necessary.
I worked up to adding the AA to the Retin-a and worked up to the chemical peels starting with very low strengths. Please do consider this before implementing any of what I have shared.
Best of luck to all.
DB
