Doctor’s Note: Best Topicals for Melasma

As dermatologists, we understand the challenges of managing melasma, which causes brown or gray-brown patches on the face. While melasma can be frustrating, several effective over-the-counter (OTC) topical treatments can help reduce its appearance. This guide explores the best OTC products for melasma and how to use them safely.

Understanding Melasma

Melasma is a common skin condition characterized by dark patches, primarily on the cheeks, forehead, nose, and upper lip. Its exact cause is not fully understood but is often related to hormonal changes, sun exposure, and genetics. Factors that can increase melanin production include:

Hormones: Fluctuations in estrogen and progesterone.
Sun Exposure: UV rays stimulate melanin production.
Genetics: A family history of melasma increases risk.

What Ingredients Lighten Melasma?

When looking for effective treatments for melasma, it's essential to understand the ingredients that can help lighten the skin. Here are some key ingredients known for their skin-lightening properties:

4 Steps to Make Pigment

Getting Nutrients: Melanocytes need oxygen and nutrients to function.
Making Melanin: Melanocytes create pigment (melanin) using an enzyme called tyrosinase.
Moving Melanin: Melanin moves from melanocytes to the skin's surface in 28 days.
Reaching the Surface: Melanin protects against UV damage and adds to skin color.

Let’s Stop These Steps

Getting Nutrients: Tranexamic acid blocks melanocytes from getting oxygen and nutrients.
Making Melanin: Hydroquinone is the strongest ingredient that stops the enzyme tyrosinase.
Moving Melanin: Retinol and niacinamide prevent pigment from moving to the top of skin.
Reaching the Surface: Retinol gets rid of old, pigmented cells to brighten skin.

As you can see, there are lots of ingredients that can help lighten dark spots. Hydroquinone is the strongest option to brighten pigment. But we don’t recommend hydroquinone for long-term use. Why? Hydroquinone, while powerful, can sometimes cause skin irritation, especially if you have sensitive skin. Using it for too long can also lead to rare problems, like making the skin darker instead of lighter. That’s why dermatologists usually suggest using hydroquinone for a limited time and under their guidance.

Best Products for Melasma

The Ordinary Niacinamide Serum

Anua 10% Niacinamide+ 4% Tranexamic Acid Serum

Good Molecules Niacinamide Serum

Paula’s Choice 10% Niacinamide Booster

Niacinamide

Niacinamide is a helpful ingredient for managing melasma because it blocks the transfer of pigment from melanocytes (the cells that produce pigment) to the skin’s surface. While this helps reduce the appearance of dark patches, it’s not the most powerful brightening ingredient since the pigment is still being made—it just stays deeper in the skin. To get the best results, niacinamide works well when combined with other ingredients like azelaic acid or vitamin C, which target the pigment production process more directly.

INKEY List Tranexamic Acid Serum

Naturium Tranexamic Topical Acid

Tranexamic Acid 5% Serum with Niacinamide 5

Skinceuticals Discoloration Defense Serum

Tranexamic Acid

Tranexamic acid is great for melasma because it stops melanocytes, the cells that make pigment, from getting the nutrients and signals they need to produce pigment. This helps reduce the extra pigment that causes dark patches on your skin. Tranexamic acid is gentle and works well for most skin types, even sensitive skin. With regular use, it can help lighten dark spots and even out your skin tone without causing much irritation.

Paula's Choice BOOST 10% Azelaic Acid Booster Cream Gel

The Ordinary 10% Azelaic Acid Suspension

Naturium Azelaic Acid Emulsion 10%

Skinceuticals Discoloration Defense Serum

Azelaic Acid

Azelaic acid is a highly effective treatment for melasma because it’s a very strong tyrosinase inhibitor, meaning it blocks the enzyme responsible for producing pigment in the skin. This makes it one of the most powerful ingredients for brightening and reducing dark patches caused by melasma. In addition to slowing down pigment production, azelaic acid has anti-inflammatory properties, helping to calm redness and irritation that can make melasma worse. It’s gentle enough for most skin types, making it a great choice for improving uneven skin tone and reducing discoloration over time when used consistently in a daily routine.

Retinol Correxion Eye Cream

Neutrogena Retinol Regenerating Cream

CeraVe Resurfacing Retinol Serum

The Ordinary Retinol

Retinol

Retinol is helpful for melasma because it works in three main ways: it helps your skin shed dark, pigmented cells on the surface, stops pigment from moving to the top layers of your skin, and slows down the process of making new pigment. However, retinol can irritate your skin, so it’s important to start with a low strength and use it slowly at first. A dermatologist can help you figure out the best way to use it. Don’t forget to wear sunscreen every day when using retinol, as it makes your skin more sensitive to the sun!

Daily Skincare Routine for Melasma

Morning Routine

Cleanser: Gentle cleanser to remove impurities.
Vitamin C: Brightens and protects against UV damage.
Niacinamide: Apply to improve skin texture.
Moisturizer: Lightweight and non-comedogenic.
Sunscreen: Broad-spectrum SPF 30 or higher.

Evening Routine

Cleanser: Remove makeup and sunscreen.
Topical Treatment: Apply chosen OTC treatment.
Moisturizer: Hydrating moisturizer to support skin barrier.

Conclusion

Managing melasma can be challenging, but effective OTC treatments are available. By incorporating the right topical products into your skincare routine, you can reduce the appearance of melasma and achieve a more even skin tone. Always remember to use sunscreen daily to protect your skin from further pigmentation.

If you have concerns about melasma or its treatment, consult a dermatologist for personalized advice. With patience and the right approach, you can effectively manage melasma and improve your skin's appearance.

FAQ

What is the best treatment for melasma?
The best treatment for melasma involves a combination of sun protection, topical treatments like hydroquinone, tretinoin, or azelaic acid, and professional procedures such as chemical peels, microneedling, or laser therapy. A dermatologist can provide a personalized treatment plan.

What is the best medicine for melasma?
The most effective medicine for melasma is often a prescription-strength topical containing hydroquinone, alone or in combination with tretinoin and a corticosteroid (commonly called triple-combination therapy). Oral tranexamic acid may also be prescribed for resistant cases.

What are the best products for melasma?
The best products for melasma include broad-spectrum sunscreens with SPF 30 or higher, lightening agents like vitamin C serums, kojic acid, and niacinamide, and gentle exfoliants such as glycolic acid. Look for products specifically designed for hyperpigmentation.

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