Hello, thank you for sharing your concern. Melasma is a chronic pigmentation disorder that can be difficult to treat, and unfortunately there is no permanent “cure.” However, many patients can achieve significant improvement with the right combination of treatment and strict sun protection.
Since your pigmentation is getting darker despite using creams, a few possibilities should be considered: • The diagnosis may need to be reconfirmed by a Dermatologist • Sun exposure or heat exposure may still be triggering pigmentation • The creams may not be the most effective option for your type of melasma • Skin irritation from multiple products may actually worsen pigmentation
For melasma, the most important treatment is: • Broad-spectrum SPF 50+ sunscreen every day • Reapplication every 2–3 hours when outdoors • Physical protection (hat, umbrella, avoiding peak sunlight)
Dermatologists commonly use treatments such as: • Hydroquinone-based creams (short-term under supervision) • Tretinoin-containing creams • Azelaic acid • Kojic acid • Triple-combination creams • Tranexamic acid in selected patients • Chemical peels or laser procedures for resistant cases
If you have already tried several creams without improvement, it may be time for a detailed dermatology review rather than continuing to switch products. Sometimes conditions that look like melasma are actually another form of pigmentation requiring different treatment.
If possible, upload a clear photograph of the affected area. A photo can help determine whether this truly appears to be melasma or another pigmentation disorder.
Prescription: 1. Continue broad-spectrum SPF 50+ sunscreen daily and reapply when outdoors 2. Avoid direct sunlight and excessive heat exposure 3. Use a gentle cleanser and moisturizer; avoid harsh scrubs and frequent product changes 4. Do not use steroid-containing fairness or skin-lightening creams without prescription 5. Dermatologist consultation advised for reassessment and consideration of advanced treatments such as hydroquinone, azelaic acid, tranexamic acid, peels, or laser therapy
Dr.Nirav Jain MBBS, D.Fam.Medicine
Melasma can be a stubborn skin condition, often exacerbated by sun exposure, hormonal changes, or even certain medications. Since the creams you’ve tried aren’t working, you might need to reassess your treatment plan. A key aspect is sun protection—ensure you’re using a broad-spectrum sunscreen with at least SPF 30 daily, even when staying indoors, as indoor lighting can also contribute to worsening pigmentation. Reapply every two hours if you’re outside for prolonged periods. Beyond sunscreen, topical treatments containing ingredients like hydroquinone, tretinoin, or azelaic acid can help lighten affected areas. If you haven’t tried these yet, discussing them with a dermatologist might be a good move. They might also consider procedural options like chemical peels, microdermabrasion, or laser therapy if topical treatments haven’t shown results. Also, evaluate any hormonal contraceptives or medications you are on, as they can sometimes worsen melasma—switching to alternative methods could potentially help. Staying consistent with your skincare routine is critical, as improvements can take several weeks or even months. Avoid known triggers, such as excessive heat from saunas or cooking, which can exacerbate the condition. If you notice any sudden changes or the pigmentation becomes inflamed or starts bleeding, seek a dermatologist’s advice immediately as it could indicate an underlying issue.
Hello
Melasma is a chronic pigmentation condition, so improvement usually takes months rather than weeks. If the pigmentation is getting darker despite treatment, common reasons include ongoing sun exposure (even through windows), heat exposure, hormonal factors, certain medications, or using ineffective or irritating creams.
The cornerstone of treatment is daily use of a broad-spectrum sunscreen with SPF 50+ and protection from direct sunlight. Prescription creams containing hydroquinone, tretinoin, and a mild corticosteroid (often called triple-combination therapy) are among the most effective topical treatments. Other options include azelaic acid, kojic acid, cysteamine, or topical tranexamic acid.
If topical treatments fail, a dermatologist may consider oral tranexamic acid, chemical peels, microneedling, or selected laser treatments. However, some lasers can worsen melasma if not used carefully, especially in darker skin types.
Since your pigmentation is worsening despite previous creams, it would be best to see a dermatologist again to confirm that it is truly melasma and not another cause of facial hyperpigmentation. The treatment plan may need adjustment, and any triggering factors should be identified and addressed.
Feel free to reach oit again Regards Take care
Hello dear Melasma is due to Suj exposure Pigmentation due to hormonal alterations Dust exposure Please do not worry and follow instructions below. Usually the appearance ranges from red inflammatory to comedonal white heads.
Medications: 1. Topical Treatments -Benzoyl Peroxide (2.5–5%) twice a day for week Salicylic Acid, Adapalene 0.1% can also be given as additive medications. 2.Clindamycin 1% Clindac A ,Tretinoin ( if already not taken). 3.Azelaic Acid 10 percent for two weeks. 4. Oral Medications -tablet Doxycycline 1 month twice a day for max 5 days or Tab Minocycline ( take precautions to avoid in pregnancy) 5.Oral contraceptives - Diane-35 with addition of Spironolactone on recommendation only by gynacologist in person only
Supportive medications Niacinamide serum –antiinflammatory in nature twice daily for 1 week In addition use aloevera - tulsi solution to apply topically for 1 month
In case of no improvement in 1 month, kindly consult dermatologist in person for better clarification There may be requirement of Laser Photdynamic therapy Electro cautery Regards
Melasma and facial hyperpigmentation can be difficult to treat, and unfortunately there is no guaranteed permanent cure, but many people achieve significant improvement with the right treatment plan and strict sun protection. If your pigmentation is worsening despite several creams, it is important to confirm the diagnosis because conditions other than melasma can look similar and require different treatment.
I recommend consultation with a Dermatologist, who can review the creams you’ve already used and discuss options such as prescription combination therapy, chemical peels, oral medications when appropriate, or laser-based treatments. In the meantime, continue daily broad-spectrum SPF 50+ sunscreen, reapply it regularly outdoors, and minimize direct sun and heat exposure, as these can worsen pigmentation even when sunscreen is used.
