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 we 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 over-the-counter products that work well for melasma 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.
What we’re looking for
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.
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 overall product to prevent melasma
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 overall product to treat melasma
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 always recommend topical vitamin C, my favorite being SkinCeuticals CE Ferulic,” says Dr. Justine Hextall of Tarrant Street Clinic in the U.K. This is also our best overall vitamin C serum — and one of my longtime favorites. 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. “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, recommends using vitamin C serum and 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, which Dr. Lal describes as “elegant,” and “nonirritating.” It can be used up to two times per day, says Lal, and uses a stabilized version of L-ascorbic acid along with sodium ascorbyl phosphate and a fruit extract blend that further helps to brighten the skin.
Best product to use at night to prevent and treat melasma
Ingredients: Adapalene | Price: 0.5 ounces ($30 per ounce)
Four of our dermatologists suggested using a retinoid to 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 as a part of only 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 people, who should not use any retinoids, according to the dermatologists we talked to.
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.
• 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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