Melasma treatment

Melasma: What are the best treatments?

Melasma is a pigmentation disorder of the skin mostly affecting women. It is a patchy dark brown or grayish discoloration of the skin on the face, such as the cheeks, nose, upper lip, and forehead. Melasma is not physically harmful, but it can lead to psychological problems and emotional well-being because it affects personal appearance.

What is the cause of melasma?

The exact etiology of melasma is unknown. External and Internal factors affect the pigment.  Genetic predisposition and environmental factors have been associated with the development of this condition. Exposure to ultraviolet (UV) radiation, pregnancy, oral contraceptives, hormonal therapy, phototoxic drugs, cosmetics and medications are all considered potential risk factors for melasma.

Can Melasma be prevented?

Melasma cannot be fully prevented. Avoiding sun exposure, regular using high-SPF sunscreens and whitening products help protect against melasma flares and reduce their recurrence after treatment.

How is melasma treated?

There are many methods used to treat melasma. Each has different efficacy and has pros and cons. Here we will separate two main topics: External care and Internal care.

External care

  1. Daily topical products are important in pigment care because we expose to internal and external factor everyday.
  • Sunscreen can protect us from sun light. The sun light can stimulate pigment and destroy our skin. We should apply sun screen everyday. Sun screen formula that can attach well on skin is highly recommend because it will not dissolve out by sweat.
  • Chemical whitening agents are widely used such as retinoic acid (Vitamin A), Hydroquinone, corticosteroid, azelaic acid, tranexamic acid, tretinoin, and alpha hydroxy acid. These products are effective, but they can cause dermatitis and some should not be used during pregnancy.
  • Natural whitening agents are very popular nowadays. The natural products are researched and developed to replace chemical substances that may affect our health. There are natural active ingredients scientifically proved to be safe and effective. The well-known agents are tomato extract, artocarpus lacucha extract, licorice root extract, natural vitamin C, and Phyllanthus Emblica fruit extract.
  1. Chemical peeling is a basic treatment for long time. It helps peel out and brighten superficial skin. But the pigment will come back again.
  2. Natural Multivitamin Treatment helps improve pigment problem and also protecting melasma recurrence. Because chemical irritation can stimulate pigment, natural multivitamin is highly recommended.
  3. Derma stamp is a method that uses very tiny needle stimulate the skin. It help improve pigment, pore size and pitted (depressed) acne scar. The new model of Derma stamp, which needle length can be adjusted, is more efficient to improve the skin.
  4. Pigment Laser is the 1st priority for melasma treatment. There are many laser models. Newest model laser develops for more effectiveness and correcting unwanted complication from old model. The newest model can improve the pigment and improve skin quality too. Piyawat Clinic serves you with the newest USFDA approved laser with high standards for safety and effectiveness.

Internal care

Internal factors such as hormones and ageing can aggravate the pigment. Therefore, supplements and oral medicine can help improve pigment.

  1. Tranexemic acid

Tranexamic acid is an antifibrinolytic, procoagulant agent approved by the Food and Drug Administration for the treatment of cyclic heavy menstrual bleeding and prevention of bleeding in patients with hemophilia undergoing tooth extraction.

Oral tranexamic acid has been used off-label in dermatology in the treatment of melasma and other hyperpigmentation disorders. Although unlikely, this medication may cause serious blood clot problems such as stroke, vision change and deep vein thrombosis.


  1. Natural supplement

Natural supplements are more recommended than chemical ones. There are some natural products that have scientific support to be safe and effective. At Piyawat Clinic, Blood Tonic is 100% natural supplement. It helps improve pigment, skin quality and hair.


Melasma is caused by multifactorial factors. Melasma treatment strategy is the combination of internal and external care to achieve the best result.

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