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On the list of common but stubborn skin concerns, melasma is pretty high up. It’s the much more stubborn sibling of post inflammatory hyperpigmentation and often the trickiest kind to treat, because it’s notoriously difficult to get rid of and doesn’t always respond well to run-of-the-mill hyperpigmentation-clearing products. Melasma is a type of skin discoloration that typically appears as dark-brown patches on the forehead, cheeks, nose, and upper lip. It affects people of all genders (and can flare up even if you’ve gone years — or your whole life — without a breakout), but according to Derma di Colore founder Dr. Carlos A. Charles, it “is more prevalent in women with darker skin tones that tan easily, but it can be seen across most skin complexions.” Two main factors that contribute to melasma are exposure to UV light and hormonal changes, so “summertime and pregnancy are common times when melasma flares up,” says Dr. Nava Greenfield of Schweiger Dermatology Group.
While Charles, Greenfield, and other dermatologists I talked to say a combination of prescription-strength medications and in-office treatments is the most comprehensive way to treat melasma, there are over-the-counter topical products you can use to help prevent and fade it. I’ve personally never had melasma, but I’ve dealt with my fair share of dark marks, and many of the best melasma treatments are tried and true for both — some of which I’ve tested and mentioned below. To round things out, I’ve spoken with dermatologists who shared their recommendations for the most effective ways to treat and prevent melasma — including a product specifically for pregnant people.
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Ingredients
On the prevention front, our experts’ top recommendation is sunscreen. “Sun and light exposure is the most common reason for the appearance of melasma,” explains Dr. Morgan Rabach of LM Medical NYC. Therefore, the first — and most essential — defense, according to all of our experts, is to liberally apply a broad-spectrum mineral sunscreen with zinc or titanium every single day no matter the weather. Melasma responds well to hyperpigmentation-fading vitamin C, which has the additional benefit of protecting skin from UV damage. Experts recommend hydroquinone, a highly effective skin-lightening agent, though one concern is that it paradoxically darkens the skin. This typically happens when it’s used for too long, which is why most dermatologists recommend it for short periods of time (around three to six months). The latest alternative to hydroquinone is cysteamine, which Dr. Karan Lal says “depigments the skin slowly and more safely than other bleaching ingredients.” Unlike with hydroquinone, you don’t run the risk of paradoxical hyperpigmentation.
Price
Skin care runs the gamut — ranging from drugstore to luxe. We’ve noted the size as well as cost per ounce (or fluid ounce), so you can choose what works best for your budget.
Best melasma prevention product overall
Ingredients: Zinc oxide, niacinamide, antiocidants | Price: 1.7 ounces (approx. $24 per ounce)
One of the best ways to deal with melasma is to prevent it, and sunscreen is the first line of defense. I’m a big fan of this sunscreen from EltaMD, which I keep in my regular rotation. It has a lotion-y consistency that spreads super easily and sinks in without a white cast. I like that it has both chemical and physical blockers, which work together to both deflect and absorb the sun’s rays. The tinted formula of the UV Clear is my favorite in particular because it works well on a wide range of skin tones, and according to dermatologists, it helps to even out patches that have already formed. Dermatologists also love the formula. Three of our experts name EltaMD’s moisturizing UV Clear, a perennial favorite of dermatologists that has received top marks in several Strategist sunscreen roundups. “This sunscreen-moisturizer combination is good for daily use as it is lightweight and does not leave any significant visible residue behind even on darker skin tones,” says Charles. It’s specifically formulated for the face, which our experts say is where melasma is most likely to strike.
Best moisturizer for preventing melasma
Ingredients: Avobenzone (3 percent), octisalate (5 percent), octocrylene (7.5 percent), peptides, and antioxidants | Price: 1.6 ounces (approx. $12 per ounce)
A moisturizer with SPF (which you can think of as a more moisturizing sunscreen) is also a good option. This one from No7 contains chemical SPF blockers along with peptides and antioxidants, which help to further protect skin from damage. “It’s a multitasking day cream good for those who want to prevent melasma and are also interested in treating fine lines,” says Dr. Tess Mauricio, a board-certified dermatologist and the founder of M Beauty Clinic. The lightweight cream gives SPF 30 protection and protects the skin against environmental damage. Miami-based dermatologist Annie Gonzalez says this is a favorite of hers and is popular with her clients, who like that it can address a few different concerns at once.
Best sunscreen for pregnant people to prevent melasma
Ingredients: Zinc oxide, titanium dioxide | Price: 1.5 fluid ounces (approx. $16 per fluid ounce)
Melasma is incredibly common during pregnancy, and while it can fade postpartum, there are still options for treating it during. You will want to be mindful of what you pick up, though, as certain ingredients, like the ones found in chemical SPF, should be avoided. Dermatologists recommend sticking to mineral sunscreen to help prevent melasma. Greenfield is a fan of this one from Belli, a brand that formulates specifically for pregnancy. This one from the brand — which is fragrance-, paraben-, and oil-free — helps to prevent melasma breakouts. “It’s formulated to be pregnancy safe, which can help prevent flares during pregnancy,” she says.
Best product to treat melasma overall
Ingredients: Hydroquinone, vitamin E, lactic acid | Price: 2 ounces (approx. $3 per ounce)
Hydroquinone is one of those much-discussed ingredients. On one hand, the FDA-approved skin-lightening agent is very effective (six of our experts named it as an extremely effective way to treat melasma flare-ups, especially via products that combine hydroquinone with other active ingredients like exfoliating acids), but it can also cause permanent skin damage if used too long or in very high concentrations. “It can take two to three months to see results,” says Dr. Y. Claire Chang of Union Square Dermatology, “and should not be used for more than three to six months at a time.” It works by inhibiting the skin’s pigment-producing cells. Chang likes Ambi Fade Cream in particular because it contains vitamin E and lactic acid to help with simultaneously exfoliating and softening skin. You should apply a thin layer only to the melasma itself, not to the rest of the skin, and wear SPF consistently to make sure no new melasma forms. And if your melasma pops up during pregnancy, you should wait until after giving birth before applying this or any other product formulated with hydroquinone.
Best serum to treat melasma
Ingredients: L-ascorbic acid, vitamin E, ferulic acid | Price: 1 fluid ounce ($169 per fluid ounce)
Vitamin C serum packs a major punch: It protects the skin against environmental damage and lightens dark patches, the latter being a big reason why three of our experts suggested using it to treat melasma. I’ve long been a fan of this serum in particular (so much so that I named it the best overall pick for vitamin C) because despite vitamin C’s notoriously fickle nature, this formulation is very stable and works to brighten and even out skin. The water-light texture smells horrid but is incredibly effective, thanks to a time-tested combination of vitamins C and E, along with ferulic acid, which help to brighten skin. To prevent degradation, Dr. Justine Hextall, dermatologist at Tarrant Street Clinic, Hextal suggests storing the serum in a cool, dark drawer. Dr. Sam Bunting, the founder of Dr. Sam’s Skincare, suggests layering it under sunscreen in the morning so it can help protect skin from free-radical damage. And Dr. Yoon-Soo Cindy Bae — who says she is very conservative when it comes to recommending products for pregnant people — says a serum like this is safe to use when expecting.
Best less expensive serum to treat melasma
Ingredients: L-ascorbic acid, sodium ascorbyl phosphate | Price: 1 fluid ounce ($20 per fluid ounce)
For a less expensive vitamin C serum, there’s this one from Naturium. I’m a fan of the brand generally — it makes a great lotion and body wash — and I’m a fan of this product’s ingredients list. Its main actives are a stabilized version of L-ascorbic acid and sodium ascorbyl phosphate, another version of vitamin C. It also contains antioxidants, which help to further protect and brighten the skin. It comes recommended by dermatologist Dr. Lal, who describes the serum as “elegant” and “nonirritating.” It can be used up to two times per day, he says.
Best product to use at night to prevent and treat melasma
Ingredients: Adapalene | Price: 0.5 ounces ($30 per ounce)
Retinoids (topical agents derived from vitamin A) encourage cell turnover and inhibit tyrosinase — the enzyme our skin needs to produce melanin — which helps to brighten and even out skin. Retinoids were the most-recommended intervention from the dermatologists I spoke to, but with a word of caution. Pregnant people should steer clear of it altogether, and since it makes your skin more sun-sensitive, it should be applied at night and followed up with sunscreen during the day. Most retinoids, like tretinoin, are available only by prescription, but Differin, which comes recommended by Bae, is an effective alternative. I mention this one a lot when I reference acne treatments. Its main ingredient is adapalene, an over-the-counter retinoid. It’s a bit less effective than a prescription option but will still get the job done, and because it’s a bit less potent, it’s not as irritating either.
Best retinoid alternative to prevent and treat melasma
Ingredients: Azelaic acid | Price: 1 ounce ($10 per ounce)
If you’re pregnant or otherwise unable to use a retinoid like that in Differin, incorporating an azelaic-acid serum can be a good stand-in. Azelaic acid is a brightening antioxidant that puts a stop to pigment production in the skin, according to Bunting, who recommended this serum by name. “For pregnancy, a simple azelaic-acid serum is best,” he advises. Chang is a fan, noting that some small studies have shown it to be as effective as hydroquinone.
Best makeup to cover melasma
Ingredients: SPF, Mineral Powder | Price: 0.32 ounces (approx. $175 per ounce)
Actress Alison Brie, who struggles with melasma, told us about this concealer palette from Colorescience when we asked her about the things she can’t live without. “It’s the only makeup that’s ever been approved by my facialist as something that’s not a terrible pore-clogger,” she says. The palette comes with a guide to explain what each shade corrects and it contains SPF for added protection from the sun.
Our experts
• Dr. Yoon-Soo Cindy Bae, dermatologist at Laser & Skin Surgery Center of New York
• Dr. Sam Bunting, dermatologist and founder of Dr. Sam’s Skincare
• Dr. Y. Claire Chang, dermatologist of Union Square Laser Dermatology
• Dr. Carlos A. Charles, Derma di Colore founder
• Dr. Annie Gonzalez, dermatologist at Riverchase Dermatology
• Dr. Nava Greenfield, dermatologist at Schweiger Dermatology Group
• Dr. Justine Hextall, dermatologist at Tarrant Street Clinic
• Dr. Karan Lal, dermatologist at Schweiger Dermatology Group
• Dr. Tess Mauricio, dermatologist and founder of M Beauty Clinic
• Dr. Morgan Rabach, dermatologist at LM Medical NYC
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