I’ve been getting so many questions about which skincare ingredients are most effective when dealing with melasma, or the type of hyperpigmentation known as the “pregnancy mask.”
Overall, the strategic combination of complementary ingredients to target different aspects of melasma is, in my opinion, the best approach. Here’s why: some ingredients slow down pigment production, while others stop the transfer of pigment from the melanin producing cells to the other cells in the skin. Other ingredients help exfoliate away the uppermost layers of pigment-stained skin, and others act as antioxidants, neutralizing the free radicals and oxidative stress that makes melasma worse. So, combinations are going to be more effective than single modalities.
But, it’s a delicate balance because we don’t want to overdo it with potentially irritating ingredients. If you cause too much irritation in the skin, this can make melasma worse.
In this post, I’ll cover both products you can get online or in stores, and ingredients that come in prescription strength, through your doctor. I’ve put together a list of the ingredients I find most effective in addressing melasma, and of course, I’ve added products in each category that I love to use:
Glycolic acid and/or lactic acid:
While in office peels are going to get you more dramatic results more quickly, you can absolutely see improvements using at home peels if you use them right!
First, look for ingredients like glycolic acid and lactic acid. If you have oily skin, you might enjoy a peel with salicylic acid, but that can be drying in more sensitive, dry skin types.
The peels you purchase online or over the counter, that are meant for at home use, tend to be much weaker than in office peels. However, you can still run into trouble. At home peels contain many of the same ingredients as in-office peels, so they do come with a risk of burn or skin irritation if used improperly.
Despite what the instructions say, the first time you use one of these at home peels, consider leaving it on for 5 minutes and then rinsing off, and immediately applying a moisturizer – this is the recommendation I make to my patients. This short exposure is a “test run” for your skin to see how you tolerate that peel. Another good rule of thumb is that tingling is ok, but stinging/burning is NOT ok. If you feel anything more than a tingle, then wash it off immediately and apply a nourishing moisturizer. Burning does NOT mean it’s working- it means it’s triggering too much inflammation in your skin and that can make your melanocytes react by pumping out MORE pigment.
If your skin feels healthy and you don’t experience any stinging/burning or red blotches in the days following the first peel trial, then you can consider leaving the product on the skin either for 10 minutes, or even overnight, depending on the strength of the product and how sensitive your skin tends to be. The goal is to try to work your way up to using one of these products twice a week at night, with each application spaced 3-4 nights apart.
Some of my favorite at home peels are:
Moon Juice Acid Potion Resurfacing Exfoliator: (glycolic, lactic and salicylic acid)
Skin Fix Correct+ Dark Spot Corrector: (glycolic acid and lactic acid)
Herbivore Botanicals Prism 12% Exfoliating Serum: (lactic, glycolic, and malic acids)
Vit C and other antioxidants (turmeric, Vitamin E, honey)
Cover FX Brightening Booster Drops (these drops have an oil soluble derivative of vitamin C called Ascorbyl Tetraisopalmitate. It’s one of the most stable forms of vitamin C and stability is critical for vitamin C because it is prone to oxidation)
Skinceuticals CE Ferulic with 15% L-ascorbic acid. (Strong science behind this one, but note that it is expensive)
Bakuchiol (a retinol alternative)
Check out my full blog post on this topic HERE.
Other topical ingredients to consider: azeleic acid, kojic acid, niacinamide, licorice root extract, mulberry extract and tranexamic acid, arbutin and soy. Licorice root seems to be more soothing, while niacinamide can cause irritation in some people. Topical tranexamic acid can sometimes help, but can also cause some irritation. Topical use is much less effective than when I prescribe tranexamic acid orally (more on this immediately below).
Turning to Prescription strength topical ingredients to address melasma:
In my office, I’ll often compound or blend my own prescription strength ingredients for my melasma patients. Oftentimes, these products combine tretinoin or tazorac (forms of prescription strength vit A) with hydroquinone. Hydroquinone is a controversial ingredient with some very real side effects, so I strongly discourage anyone from using this ingredient if they are not under the direct supervision of a dermatologist. I have an entire post on the safety of hydroquinone here. I talk about the risks and benefits of these treatments with my patients, and customize my approach for each patient based on their pigment pattern, medical history, budget and comfort level.
For info on how to address your melasma from the inside out through diet and supplements, check back soon!