Melasma, a common form of skin discoloration that typically appears as dark-brown patches on the forehead, cheeks, nose, and upper lip, can be exceedingly frustrating to get rid of. It affects both men and women (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 hormone changes, so “summertime and pregnancy are common times when melasma flares,” adds Dr. Nava Greenfield of Schweiger Dermatology Group.
While Charles, Greenfield, and the five other dermatologists we talked to say a combination of prescription-strength medications and in-office treatments is always the most comprehensive way to treat melasma, there are over-the-counter topical products you can use to help prevent and fade it. Below, our experts’ recommendations for the most effective over-the-counter ways to treat and prevent melasma, including a couple of products specifically picked for pregnant women.
Best overall product to prevent melasma
“Sun and light exposure is the most common reason for the appearance of melasma,” explains Dr. Morgan Robach 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. Three of our experts name EltaMD’s moisturizing UV Clear SPF 46, 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, and our experts say that’s where melasma is most likely to strike. Two of the three dermatologists who recommended EltaMD suggest using the brand’s tinted formula, which offers the same skin protection and will also help even out dark patches of melasma that may have already formed.
Best overall product to treat melasma
Hydroquinone is an FDA-approved skin-lightening agent that works by inhibiting the skin’s pigment-producing cells. Four 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. Glytone Dark Spot Corrector, which came recommended by Dr. Yoon-Soo Cindy Bae of Laser & Skin Surgery Center of New York. The product combines hydroquinone with the exfoliant kojic acid; the acid will work to exfoliate discolored skin, while the hydroquinone prevents new discoloration from forming. You should apply a thin layer of the corrector only to the melasma itself, though, not to the rest of the skin. And if your melasma pops up during pregnancy, you should wait until after giving birth before applying this or any product formulated with hydroquinone.
Best sunscreen for pregnant women to prevent melasma
If you’re pregnant, Greenfield recommends this 100 percent mineral sunscreen — which is also fragrance, paraben, and oil free — as one to use to help prevent melasma breakouts. “It’s formulated to be pregnancy safe, which can help prevent flares during pregnancy,” she says.
Best brightening serum to treat melasma
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 when it erupts. “I always recommend topical vitamin C, my favorite being SkinCeuticals CE Ferulic,” says Dr. Justine Hextall of Tarrant Street Clinic in the U.K. “This formulation is very stable, which is important as vitamin C is easily degraded by light and heat exposure.” To further prevent degradation, Hextal suggests storing the serum in a cool, dark drawer. Dr. Sam Bunting, the founder of Dr Sam’s Skincare, also recommends using vitamin-C serum and suggests layering it under sunscreen in the morning so it can help protect skin from free-radical damage as it works to brighten. And Bae — who says she is very conservative when it comes to recommending products for pregnant women — says a serum like this is safe to use when expecting.
Best moisturizer to treat melasma
This moisturizer, recommended by Robach, uses the combined power of skin brighteners niacinamide and tranexamic acid to fade discoloration. “SkinMedica Lytera is a moisturizer that has antioxidants that will help skin even out (even if tan!) and can be used in women that are pregnant,” she says. Dr. Nancy Samolitis, the co-founder and medical director of Facile Dermatology + Boutique in L.A., also likes it for soothing melasma eruptions. “Lytera is packed with gentle brighteners and can be used in the morning with an antioxidant serum.”
Best product to use at night to prevent and treat melasma
Four of our dermatologists suggested using a retinoid to both prevent and combat melasma flare-ups. Because retinoids (topical agents derived from vitamin A) encourage cell turnover and inhibit tyrosinase — the enzyme our skin needs to produce melanin — they can lead to “brighter, more even-toned skin,” according to Bunting. Since they make your skin more sun-sensitive, the experts say you should use retinoids only as a part of your nightly routine. Many are available only by prescription, but Bae cites Differin, which contains the retinoid adapalene, as an affordable over-the-counter option — except for pregnant women, who should not use any retinoids, according to the dermatologists we talked to.
Best retinoid alternative to prevent and treat melasma
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.
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