Melasma Treatment


Before and after laser for melasma pigmentation
Before and after homecare and qswitch laser for melasma pigmentation at our Sydney clinic

What is Melasma?   

Melasma manifests as irregular brown/ tan or blue-gray patches in a symmetrical pattern on sun-exposed areas of the face. It typically appears on the upper cheeks, top lip, forehead and chin of women aged 20-50 years. Rarely, it can affect other body areas like the arms. It is uncommon in men.

It is more common in people with olive or dark skin (i.e. Latina/Asian/Hispanic and Middle Eastern descent) but affects people with fair skin, as well.

If it presents during pregnancy it is better known as chloasma or “the mask of pregnancy”. Chloasma tends to resolve within 6 months of delivery.

What is Melanin?

Melanin is a pigment produced by skin cells called melanocytes.  If these cells mutate and become cancerous they form a melanoma. Melanin protects our skin’s DNA from ultraviolet radiation (sun damage). Fair skinned people have less melanin, therefore they burn easier than dark skinned people.


What causes melasma?

The exact cause is not known, but we do know that several factors play a role.  These include:

  • UV radiation (sun exposure)
  • Dark skin type (as mentioned previously)
  • Hormonal factors (both estrogen and progesterone)
  • Genetic predisposition
  • Thyroid dysfunction
  • Telangiectatic melasma  (underlying hypervascularity)

It is important to exclude other causes of abnormal pigmentation, which can include:

  • Certain medications i.e. Amiodarone/anti-epileptic medication
  • Post inflammatory hyperpigmentation
  • Allergic contact dermatitis (often from cosmetics)
  • Poikiloderma of the Civatte (commonly found on side of neck)
  • Nevus of Ota (bluish or brownish pigmentation in whites of the eye and surrounding eye area)
  • Actinic Lichen Planus
  • Exogenous ochronosis (rare side-effect of high dose and prolonged use of Hydroquinone, this is why we only recommend a 3 month course)


How can we treat/control it?

Melanin in the superficial layer (epidermis) of the skin is relatively easy to treat and responds well to topical agents such cosmeceuticals /chemical peels and laser therapy. However melasma often affects both the superficial and deeper (dermis) layers. This mixed type is more challenging to treat and it could take weeks to months to see an improvement.

In order to treat melasma, combination or specially formulated creams may be prescribed. The ingredients in these creams have the ability to slow down the production rate of melanin by the melanocytes.  

  • Hydroquinone (remains the gold standard)
  • Vitamin A / Tazoratene 
  • Adapalene 
  • Azelaic acid  (safe to use in pregnancy)
  • Vitamin C
  • Resorcinol
  • Kojic acid
  • Lactic acid lotions
  • Glycolic acid creams
  • Arbutin
  • Liquorice root
  • Sunscreen

We usually recommend the following regime:

  • Compounded formula lightener Vitamin A to be applied at night ONLY for 3 months (Only available by doctor’s prescription)
  • Results are then maintained by prescription strength Vitamin A at night
  • Results can be enhanced by using Vitamin C in the morning
  • Avoid combining Vitamin C with Vitamin A, to ensure full efficacy of both ingredients.  Always use Vitamin A in the evening and Vitamin C in the morning.
  • Sunscreen and hat use as directed

Sunscreen use and sun avoidance (whenever possible) is not negotiable in melasma sufferers.  The use of broadspectrum sunscreen (UVA + UVB) with physical blockers like titanium dioxide and zinc dioxide is preferred over chemical sunscreens.

Heat should be avoided, eg sunbeds, sun, saunas or hot yoga

Melasma is a bothersome condition and cannot be cured but is very possible to control.  

Very gentle chemical peeling (eg glycolic or lactic) can be performed, but in the wrong hands it can make your melasma worse.

There are specific lasers that are more specific to melasma. Patients often require a series of these to achieve the desired results and it is advisable to prepare the skin with lighteners for at least 4 weeks prior to a treatment. QSwitch laser is the most popular laser to address melasma. We often use a combination of Qswitch laser and excel V.

In cases of telangiectatic melisma it is important to address the underlying vascular cause, in these cases Laser Genesis or Excel V can be used.

New Treatment options?

Oral tranexamic acid has recently been proven in multiple studies to improve melasma.  A single tablet is taken daily with results from 8 weeks onwards. Currently a 3 month course is being advocated.

This treatment is not suitable in people with clotting disorders or previous stroke/ DVT/ pulmonary embolism.


Interesting facts

People of all races have the same amount of melanocytes, the difference lies in the type of melanin and the amount of melanin being produced.

There are 3 types of melanin in the human body:

  1. Eumelanin: which has 2 variations – black and brown.
  2. Pheomelanin (red): which is responsible for all our pink bits (think lips/nipples/genitalia) and red hair.
  3. Neuromelanin: which is found in the brain and has to do with dopamine production.  Loss of this melanin can cause neurological disorders.

Which devices can be used for melasma?

At The Manse Clinic, we offer multiple treatments and devices to treat melasma, including the following:

  • The Manse Glow: A combination of Qswitch laser and a (doctor only) Vitamin A peel and an LED.
  • Qswitch laser
  • Laser Genesis (for telangiectatic melasma)
  • Excel V (for telangiectatic melasma)
  • Sciton BBL
  • Chemical Peel
  • Fractional non-ablative laser
  • Fractional ablative laser

Please see some pigmentation and melasma before and after images

The Following video is for The Manse Glow.

368 thoughts on “Melasma Treatment

  1. Pingback: Drug Rehab Near Me

  2. Pingback: Drug Rehab

  3. Pingback: Alcohol Rehab Near Me

  4. Pingback: buying viagra online forums

  5. Pingback: viagra price in india online purchase

  6. Pingback: how do you get viagra

  7. Pingback: how to buy viagra over the counter uk

  8. Pingback: viagra super force

  9. Pingback: buy sildenafil usa

  10. Pingback: buy essays online

  11. Pingback: cialis online

  12. Pingback:

  13. Pingback: dissertation service

  14. Pingback: help writing an essay

  15. Pingback: writing essay service

  16. Pingback: i need help writing my research paper

  17. Pingback: education thesis

  18. Pingback: help writing thesis statement

  19. Pingback: write my biology paper

  20. Pingback: can i take my iron pill with augmentin

  21. Pingback: cheap viagra online

  22. Pingback: viagra erection

  23. Pingback: liquid cialis

  24. Pingback: dose keflex for tooth abscess

  25. Pingback: cheap cialis

  26. Pingback: cialis generic name

  27. Pingback: cialis without a doctor prescription

  28. Pingback: tadalafil cheap

  29. Pingback: ciprofloxacin hcl 500 mg antibiotics

  30. Pingback: oxybutynin turns pee orange

  31. Pingback: viagra price comparison

  32. Pingback: is viagra government funded

  33. Pingback: muscle relaxer tizanidine

  34. Pingback: pills like viagra over the counter

  35. Pingback: detox from abilify

  36. Pingback: over the counter viagra substitute walgreens

  37. Pingback: allopurinol vs indomethacin

  38. Pingback: amiodarone user reviews

  39. Pingback: elavil medication for sleep

  40. Pingback: side effects of amlodipine besylate

  41. Pingback: amoxicillin liver

  42. Pingback: aripiprazole mdma interaction

  43. Pingback: drugstore online

  44. Pingback: atorvastatin hs

  45. Pingback: can you take ibuprofen with azithromycin

  46. Pingback: best online canadian pharmacy

  47. Pingback: prescription drugs prices

  48. Pingback: ed meds online without doctor prescription

  49. Pingback: is baclofen

  50. Pingback: discount pharmacy

  51. Pingback: does aleve interact with baclofen

  52. Pingback: wellbutrin medication

  53. Pingback: buspar dose

  54. Pingback: melatonin buspirone

  55. Pingback: is carvedilol an arb

  56. Pingback: celecoxib 200mg cost

  57. Pingback: celexa weight gain

  58. Pingback: vardenafil hcl 20mg

  59. Pingback: fucking on viagra

  60. Pingback: sister viagra

  61. Pingback: tadalafil 5 mg

  62. Pingback: viagra working

  63. Pingback: viagra canada

  64. Pingback: cialis erections

  65. Pingback: viagra diabetes

  66. Pingback: when will cialis go generic

  67. Pingback: viagra girl horny real

  68. Pingback: cialis buy australia online

  69. Pingback: buy cialis 20mg tablets

  70. Pingback: cost of cialis without insurance

  71. Pingback: mastercard generic cialis

  72. Pingback: can i buy cialis online

  73. Pingback: monthly cost of cialis without insurance

  74. Pingback: chewable cialis

  75. Pingback: how to buy cialis online uk

  76. Pingback: viagra with script

  77. Pingback: cialis online australia

  78. Pingback: can i take amoxicillin with food

  79. Pingback: azithromycin 250 mg

  80. Pingback: eliquis and celebrex

  81. Pingback: cephalexin side effects in women

  82. Pingback: can i buy cialis in toronto

  83. Pingback: cymbalta caffine pills

  84. Pingback: amoxicillin allergy symptoms

  85. Pingback: buy cheap cialis overnight

  86. Pingback: side effects of azithromycin 250 mg

  87. Pingback: cialis soft tablet

  88. Pingback: celecoxib routes

  89. Pingback: can you take keflex with ativan

  90. Pingback: cymbalta lawsuits 2016

  91. Pingback: generic sildenafil citrate 50 mg

  92. Pingback: venta cialis madrid

  93. Pingback: cost of cialis without insurance

  94. Pingback: buy cheap cialis uk

  95. Pingback: cost of cialis without insurance

  96. Pingback: sildenafil vs viagra

  97. Pingback: cost of cialis without insurance

  98. Pingback: chewable viagra

  99. Pingback: cialis cost per pill

  100. Pingback: viagra connect

  101. Pingback: levitra coupon

  102. Pingback: canadian cialis

  103. Pingback: what is levitra

  104. Pingback: what is tadalafil 20mg

  105. Pingback: generic viagra

  106. Pingback: cialis copay card

  107. Pingback: viagra bdsm

  108. Pingback: buying viagra online

  109. Pingback: better than viagra

  110. Pingback: marley drug viagra

  111. Pingback: reddit viagra

  112. Pingback: buying viagra

  113. Pingback: cialis for bph

  114. Pingback: cialis coupon

  115. Pingback: cheap cialis

  116. Pingback: writing thesis proposal

  117. Pingback: custom college essay writing service

  118. Pingback: dissertation proposal template

  119. Pingback: thesis formatting

  120. Pingback: professional essay writers review

  121. Pingback: top custom essays

  122. Pingback: umi dissertations

  123. Pingback: custom handwriting paper

  124. Pingback: cialis without precription

  125. Pingback: mail order sildenafil citrate

  126. Pingback: cialis 20mg dosage

  127. Pingback: viagra damaged penis

  128. Pingback: cialis dosage recommendations vs viagra

  129. Pingback: viagra for women effect

  130. Pingback: does cialis cause mood swings

  131. Pingback: cialis models

  132. Pingback: sildenafil generic 50mg cheap

  133. Pingback: generic viagra reviews

  134. Pingback: wife takes viagra

  135. Pingback: generic cialis (tadalafil) 20mg

  136. Pingback: online pharmacy school

  137. Pingback: prescription drugs online without

  138. Pingback: best online to buy cialis

  139. Pingback: compounded tadalafil troche

  140. Pingback: teva 5343 vs viagra singapore

  141. Pingback: sildenafil 50mg buy

  142. Pingback: sildenafil online purchase india

  143. Pingback: acheter viagra online

  144. Pingback: cialis purchase online australia

  145. Pingback: sildenafil 50 mg

  146. Pingback: sildenafil 100mg sale from india

  147. Pingback: comprar sildenafil

  148. Pingback: karl malden viagra

  149. Pingback: viagra purchase australia

  150. Pingback: viagra pill cheap

  151. Pingback: cheap canadian generic viagra

  152. Pingback: viagra pill images australia

  153. Pingback: generic cialis 2018 usa

  154. Pingback: sildenafil soft tabs 100mg

  155. Pingback: cialis plans to go otc

  156. Pingback: sildenafil precio walmart

  157. Pingback: tadalafil tablets ip 20 mg

  158. Pingback: cialis 20mg usa

  159. Pingback: sildenafil 58

  160. Pingback: canadian prescription drugs

  161. Pingback: tricare prior authorization form for levitra

  162. Pingback: online canadian discount pharmacy

  163. Pingback: Zakhar Berkut hd

  164. Pingback: Viagra Professional

  165. Pingback: 4569987

  166. Pingback: cheap canadian cialis

  167. Pingback: original cialis

  168. Pingback: cialis original for sale

  169. Pingback: buy tadalafil uk

  170. Pingback: news news news

  171. Pingback: who profits from hydroxychloroquine

  172. Pingback: psy

  173. Pingback: psy2022

  174. Pingback: projectio-freid

  175. Pingback: buy tretinoin cream

  176. Pingback: consumir viagra es peligroso

  177. Pingback: el viagra se vende por unidad

  178. Pingback: payday loan business model

  179. Pingback:

  180. Pingback: topvideos

  181. Pingback: video

  182. Pingback: mail order viagra

  183. Pingback: ordering online australia

  184. Pingback: ordering online australia

  185. Pingback:

  186. Pingback: Ukrainskie-serialy

  187. Pingback: site

  188. Pingback: cialis from india

  189. Pingback: drug categories viagra cialis

  190. Pingback: buy ativan online overnight

  191. Pingback: how long does cialis last?

  192. Pingback: top

  193. Pingback: prescription drugs kidney stones

  194. Pingback: pharmacy canada online

  195. Pingback: cialis lilly price

  196. Pingback: canadian pharmacy ship to us

  197. Pingback: cialis free trial voucher 2018

  198. Pingback: buy cialis pills

  199. Pingback: sildenafil citrate 20mg

  200. Pingback: cialis recommended dosage

  201. Pingback: viagra dosage

  202. Pingback: tadalafil 10mg

  203. Pingback: substitute for viagra

  204. Pingback: cialis by mail

  205. Pingback: generic viagra 2017

  206. Pingback: cialis sales

  207. Pingback: 100 mg viagra

  208. Pingback:

  209. Pingback: gabapentin 800 mg

  210. Pingback: cvs cialis price

  211. Pingback: levitra generic price

  212. Pingback: chelovek-iz-90-h

  213. Pingback:

  214. Pingback: online viagra purchase

  215. Pingback: metoprolol vs amlodipine

  216. Pingback: lipitor lawsuit

  217. Pingback: meloxicam

  218. Pingback: metoprolol succinate recall

  219. Pingback: losartan potassium 100mg

  220. Pingback: viagra online

  221. Pingback: canadianmed cialis

  222. Pingback: levitra coupon code

  223. Pingback: duloxetine 20mg cap

  224. Pingback: prednisone dosage

  225. Pingback: interactions for amitriptyline

  226. Pingback: cymbalta dosage

  227. Pingback: water pill hydrochlorothiazide

  228. Pingback: metformin benefits

  229. Pingback:

  230. Pingback: warnings for mirtazapine

  231. Pingback: bupropion side effects

  232. Pingback: buspar dosage

  233. Pingback: celexa side effects

  234. Pingback: zanaflex vs flexeril

  235. Pingback: wellbutrin 150 mg

  236. Pingback: interactions for diclofenac potassium

  237. Pingback: clonidine side effects

  238. Pingback: side effects for finasteride

  239. Pingback: carvedilol tablet

  240. Pingback: metronidazole dosage

  241. Pingback: bender na4alo 2021

  242. Pingback: blogery_i_dorogi

  243. Pingback: blogery_i_dorogi 2 blogery_i_dorogi

  244. Pingback: cialis with dapoxetine

  245. Pingback: 150 mg viagra

  246. Pingback: does cialis work

  247. Pingback: prednisone dose pack instructions

  248. Pingback: sildenafil tablets 150mg

  249. Pingback: vardenafil buy

  250. Pingback: what countries sell hydroxychloroquine over the counter

  251. Pingback: priligy india generic

  252. Pingback: acyclovir dosage

  253. Pingback: snapchat dating free

  254. Pingback: amoxicillin 500 mg capsules

  255. Pingback: aricept 5 mg

  256. Pingback: amoxicillin for dogs

  257. Pingback: azithromycin tablet

  258. Pingback: cefdinir generation

  259. Pingback: buy keflex online

  260. Pingback: clindamycin 300 mg

  261. Pingback: erythromycin 250mg

  262. Pingback: cialis 50 mg tablets

  263. Pingback: cialis 200mg price

  264. Pingback: cialis daily generic

  265. Pingback: viagra 100mg tablets

  266. Pingback: cialis 20mg

  267. Pingback: online medication cialis

  268. Pingback: purchase levitra

  269. Pingback: blue pill viagra

  270. Pingback: cialis daily south africa

  271. Pingback: tadalafil generic price

  272. Pingback: hydroxychloroquine brand

  273. Pingback: cheap viagra

  274. Pingback: daily viagra

  275. Pingback: sildenafil vs tadalafil

  276. Pingback: chernaya vodova

  277. Pingback: 66181

  278. Pingback: viagra pills

  279. Pingback: buy sildenafil pills

  280. Pingback: best online viagra

  281. Pingback: viagra 100

  282. Pingback: amlodipine and viagra

  283. Pingback: cialis 100mg review

  284. Pingback: how levitra works

  285. Pingback: metformin hcl 500 mg

  286. Pingback: purchase peptides tadalafil

  287. Pingback: Porno

  288. Pingback: vechernyy urgant

  289. Pingback: ukraine

  290. Pingback: amoxicillin 500mg capsules price

  291. Pingback: doxycycline 100mg side effects

  292. Pingback: lasix 40 mg cost

  293. Pingback: xenical pills for sale

  294. Pingback: dapoxetine

  295. Pingback: proscar

  296. Pingback: careprost eye drops

  297. Pingback: clomid induction

  298. Pingback: A3ixW7AS

  299. Pingback: fluconazole dosing adult

  300. Pingback: domperidone fda import alert

  301. Pingback: how much hydroxychloroquine for 200 pound person

  302. Pingback: nolvadex 10mg

  303. Pingback: hydroxychloroquine 25 mg

  304. Pingback: prednisone vs prednisolone cat

  305. Pingback: naltrexone hcl 3mg

  306. Pingback: generic drug for valtrex

  307. Pingback: ondansetron with tizanidine

  308. Pingback: tadalafil price uk

  309. Pingback: daily cialis reviews

  310. Pingback: plaquenil 200mg tablets

  311. Pingback: hydroxychloroquine antiviral

  312. Pingback: gidonline-ok-google

  313. Pingback: ciprofloxacin chlamydia

  314. Pingback: link

  315. Pingback: cialis tablet

  316. Pingback: cialis capsule 5mg

  317. Pingback: viagra sildenafil

  318. Pingback: virectin vs viagra

  319. Pingback: sildenafil viagra

  320. Pingback: KremlinTeam

  321. Pingback:

  322. Pingback:

  323. Pingback:

  324. Pingback:

  325. Pingback: Suicide Squad 2

  326. Pingback: lowest price on cialis 200 mg

  327. Pingback: what would happen if a woman takes viagra

  328. Pingback: psiholog

  329. Pingback: buy cialis no prescription

  330. Pingback: viagra 100mg price per pill

  331. Pingback: hizhnyak-07-08-2021

  332. Pingback: silkroad online pharmacy

  333. Pingback: viagra government funded

  334. Pingback: vipps certified canadian pharmacies

  335. Pingback: ansel zovirax fennewald

  336. Pingback: zithromax capsules price

  337. Pingback: generic viagra in usa

  338. Pingback: ivermectin 12

  339. Pingback: cipa certified canadian pharmacy

  340. Pingback: ivermectin 4

  341. Pingback: ivermectil ingredients ivermectil

  342. Pingback:

  343. Pingback:

  344. Pingback: 2cholesterol

  345. Pingback: www.divephotoguide.comuserpharmaceuticals

  346. Pingback: viagra

  347. Pingback: www.formlets.comformsv7CoE3An9poMtRwF

  348. Pingback:

  349. Pingback: sildenafil citrate

  350. Pingback:

  351. Pingback:

  352. Pingback:

  353. Pingback:

  354. Pingback: revatio

  355. Pingback: online canadian pharmacies

  356. Pingback: canadian pharmacies that ship to us

  357. Pingback:

  358. Pingback:

  359. Pingback: linktr.eecanadianpharmacy

  360. Pingback:

  361. Pingback:

  362. Pingback:

  363. Pingback: buy cialis without a doctor's prescription

  364. Pingback:

  365. Pingback:

  366. Pingback:

  367. Pingback:

  368. Pingback:

Leave a Reply

Form is not available. Please visit our contact page.