Topical Treatment Options for Melasma Treatment

The most effective approach to treating melasma combines medical-grade topical therapies with advanced laser treatments such as PRP, Moxi, and Sciton BBL for optimal skin brightening and pigment reduction.

Here are the topical treatments most commonly used to treat melasma, often as part of a customized regimen:

1. Hydroquinone (HQ)

• Gold-standard skin lightener

• Inhibits melanin production by blocking tyrosinase

• Available in 2% OTC and up to 4%+ by prescription

• Often used in short cycles (3–6 months) to avoid rebound pigmentation

2. Triple Combination Cream

• Hydroquinone + Tretinoin + Corticosteroid (e.g., Tri-Luma)

• Targets pigment, skin cell turnover, and inflammation all at once

• Highly effective for moderate to severe melasma

3. Retinoids (e.g., Tretinoin, Adapalene)

• Increase skin cell turnover

• Help fade pigmentation and allow better penetration of other topicals

• May cause dryness or irritation initially

4. Azelaic Acid

• Anti-inflammatory + pigment-reducing

• Safe for long-term use and during pregnancy

• Often used in sensitive skin or as a hydroquinone alternative

5. Kojic Acid

• Natural melanin inhibitor derived from fungi

• Often found in combination products with arbutin or vitamin C

• Mild but effective with consistent use

6. Tranexamic Acid (Topical)

• Reduces pigment by blocking pathways triggered by UV and hormones

• Can be used topically or taken orally under medical supervision

• Great for stubborn or hormonally driven melasma

7. Niacinamide (Vitamin B3)

• Reduces melanin transfer from melanocytes to skin cells

• Calms inflammation and supports the skin barrier

• Pairs well with most other topicals

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