Melasma Home Remedies

The Science of Melasma Treatments at Home

• Using the correct sunscreen formulation in the correct manner is the first step
• Iron oxides via mineral makeup is the second step
• Natural ingredients include azelaic acid, beta arbutin, & vitamin C
• AM routine goes like this: Vitamin C, E, + SPF + Mineral makeup
• PM routine goes like this: Azelaic acid 10-15%
• Once a week: AHA serum 10-15%
• Supplement with glutathione & polypodium extract

What are the steps required to treat melasma?

Though results from in-clinic treatments are far more effective in clearing pigmentation & melasma, there are simple at-home remedies that may be effective. I will go through a 3 step process that is cost effective.

• Radiation protection with sunscreen & mineral makeup
• Basic skin care for pigmentation.
• Intermediate skin care

Why is sunscreen the most important step of the process?

Melasma is super sensitive to UVA & UVB as well as visible light, hence sunscreen forms the foundation of melasma management. Everyone gets collateral exposure, even if you work from home, or rarely venture out. If there is light, there is background radiation.

How do I use sunscreen properly?

95% of melasma patients do not know how to properly use sunscreen. Let’s learn how to, by a dermatologist in 2 simple steps.

• Apply after using antioxidants in the morning (vitamin C, E, ferulic acid). Apply 3-5 mls or ¾ to 1 teaspoon to the head & neck.
• Reapply in the afternoon or sooner if you have significant UV exposure.

Apply sunscreen regardless of sun exposure

What are adjunctive methods of sun protection?

Iron oxide. That’s correct. It’s the magic ingredient after sunscreen. Why? Because it gives you HEV or blue light protection, in addition to other visible light. It also can be formulated for a specific shade, hence color matching to your skin.

Iron oxide can be found in some sunscreen products, namely Melan 130, Jane Iredale Glow time & other tinted formulations. The problem lies in a color match for your skin tone. This especially applies to darker – ethnic skin types.

Here is the solution, concentrate on buying a non-tinted sunscreen if color match is an issue. Augment your protection with mineral makeup with iron oxide in your shade. This ensures you have UVB, UVA & visible light protection in your shade. Job done.

What is a basic skincare routine for pigment & melasma?

Step 2 consists of pigment correctors that can be found online.

AM: Vitamin C, E, ferulic acid. SPF then iron oxide mineral make up

PM: Azelaic acid 10-20% concentration

What is an intermediate skincare routine for pigment?

Add glycolic acid serum 10-15% every 7 to 14 days. Do this after week 6 of your basic skincare routine. Do not add this to your routine if-

• You don’t understand how your skin reacts to topicals
• If you use other skincare products that may reduce your skin’s barrier function
• If you suffer sensitive skin

When should I restart my skincare routine after a chemical peel?

Post Cosmelan peel, you will be transitioning the Cosmelan 2 program which entails the use of products to be used at home.
For other peeling agents, you can transition back to your skin care 1-10 days post procedure.

What are chemical peels & should I do it at home?

Chemical peels are effective treatments for melasma & pigmentation. Prior to the invention of lasers AHA & TCA peels were the standard of treatment, however these peels were hampered with rebound pigmentation & melasma recurrences.

I do not endorse home chemical peels (in the context of melasma). Why? Because if you get it wrong pigment can be 10 times worse. Off the record, here are my thoughts.

Safest peels? Salicylic acid 10-20% home peel as it requires no neutralization. The same goes for TCA at around 8%. Retinoic acid, if you can find a good formulation, is also safe.

Dangerous peels? Glycolic & lactic acid. Screw up the neutralization process & its post inflammatory hyperpigmentation for months to years.

Why are AHA serums safer than peels?

Glycolic acid serums are far safer than peels because they are pH controlled. This controls the availability of free acids. Serums have a high pH & are buffered compared to glycolic acid peels.

Introduce a AHA 10-15% serum every 7 to 14 days at week 6 to 8 of your melasma at home treatment. It works by exfoliation of surface pigment & increased absorption (priming) of skin.

What about DIY Cosmelan peels or Dermamelan peels?

Safer than glycolic, but ideally you should be guided as to how to modulate the post peel inflammation. These peels are effective in about 50-60% of melasma cases.

A safe & practical home solution is; Cosmelan mask in office, followed by Cosmelan 2 at home (for 3 to 4 months).

What about microneedling for melasma?

Microneedling is an awesome treatment, but not for melasma. If you want to try this at home, the biggest advice I can give you is to –

• Use a stamping device. This is far safer than a roller, & easier to use than an imitation Dermapen or SkinPen.
• Stick with 0.2 mm stamping needles. Do NOT go deeper.

The aim of microneedling is to increase the permeation of skin care actives & pigment correctors. You can add azelaic acid, vitamin C or a mix of botanicals such as licorice root, soy, bearberries & arbutin directly after microneedling.