Topical Therapy :
- Sunscreens form the most essential part of treatment of melasma. A variety of
- Depigmenting agents : various depigmenting agents are available that includes Hydroquinone, Kojic acid, Glycolic acid, Retinoic acid etc can aid in the treatment of melasma.
- Anti-oxidants form an integral adjuvant treatment. They help prevent oxidative stress caused to the body.
- Tranexemic acid:
- Hormonal therapy.
- Chemical Peels: Superficial peels such as Glycolic acid peels and Salicylic acid peels; moderately deep peels such as 50% glycolic acid and TCA, as well as deeper peels such as Cosmelan can be used to treat melasma.Usually 4-6 sessions are neede at an interval of 2-6 weeks. Deeper peels like COSMELAN peel may be neede at a much lesser interval, at times as less as 1 session every year.
- Lasers: Q switched NdYag and Light systems like the IPL are good treatment options.
- Meso therapy has also been successful in treating melasma depending upon the depth and intensity of pigment.Various cocktails of ready meso solutions containing varying proportion of depigmenting agents are available for use. Mesotherapy involves delivery of these agents directly into deeper layers of skin for better and quicker response.
Once the pigmentation has cleared, a maintenance treatment with sunscreens and skin lightening products must be continued to prevent recurrences. Maintenance treatments once in two or three months are advised in stubborn cases of Melasma.