How NOT to treat melasma.
In allopathic medicine, melasma is usually treated by the use of tretinoin (Retin-A) or another aggressive resurfacing Vitamin A derivative, in addition to the tyrosinase inhibitor (lightening agent) hydroquinone, or a corticosteroid. Sometimes a topical cream containing all three ingredients, known as a “triple cream” is used.
In the medical spa environment, melasma is often combated with the use of chemical peels, microdermabrasion, and laser resurfacing or IPL treatments.
To all of this I say NO.
Retin-A and other retinols, are not a good choices because, while they may offer a temporary fix, they cause more damage long-term because they inflame and generate free radicals in the skin, and irreparably thin the dermis and damage the collagen and elastin-producing cells within it. It also causes the skin to be hypersensitive to the sun’s UV rays, as well as other elements, which actually makes the skin more susceptible to hyperpigmentation. Corticosteroids are also a quick fix, but are generally not recommended for long-term use due to safety issues. They can also contribute to Candida overgrowth.
Hydroquinone is a fairly controversial ingredient. It is the most popular and commonly used lightening agent on the market because it works. It is available OTC in lower percentages, or double that strength as a prescription. It works by suppressing melanin production. If you recall, melanin is there for a reason: to protect against UV rays. Therefore, suppressing its production will also make the skin more sensitive and vulnerable to UV damage, which in turn will cause more hyperpigmentation. Kind of an oxymoron don’t you think? “Its irritancy level can result in Exogenous Ochronosis, a permanent, deep bluish/black stain in the skin” as well.
Furthermore, there have been reports that suggest hydroquinone is toxic; specifically that it is carcinogenic and a neuro-toxin. It has already been banned in some countries that have stricter regulations on toxic and chemical ingredients than we do in the US. Doctors who prescribe hydroquinone do not recommend it for long-term use, but many people ignore this because they like the results it produces. It is on the “toxic 12” list of cosmetic ingredients as well. Further studies have been ordered by the FDA under the National Toxicology Program. For any and all of these reasons, I strongly advise against using this ingredient.