How to Cure Melasma from the Inside

Melasma is very common, with more than 5 million people affected by the skin condition and 200,000 new cases every year, characterized by uneven brown or gray dark spots appearing on the skin’s surface. While the exact cause of the condition is not known, studies have shown that sun damage, unprotected exposure to UVA and UVB rays of light, and hormonal imbalances, such as those that occur during pregnancy or while on birth control pills, considerably worsen the discoloration associated with melasma. Melasma tends to affect patients with darker skin types at a higher rate than patients with lighter skin color due to the higher concentrations of melanin and the activity of melanocytes in darker skin. Melasma cannot be completely cured, leading patients to wonder if there are methods that are effective in managing the condition and depigmenting the affected areas. At board-certified dermatologist Dr. Michele Green’s New York City dermatology office, she knows that the best way to improve the appearance of melasma is to pair topical and in-office treatments with lifestyle changes.

Natural remedies and lifestyle changes can help to address the root causes of melasma, decreasing the likelihood of future flare-ups of the skin condition. The most essential at-home melasma prevention strategy is to always use sun protection before going outside. Dr. Green recommends applying sunscreen with SPF 30 or higher every morning and reapplying every two hours that you are outside. In addition to sun protection, a healthy diet, regular exercise, and stress reduction can reduce melasma flare-ups. Supplements containing vitamin C, vitamin E, vitamin B12, and vitamin A can be taken along with at-home topical treatments like aloe vera and turmeric to reduce inflammation and increase skin health. Lifestyle changes and natural remedies will work best when paired with topical treatments and in-office procedures that an expert dermatologist like Dr. Michele Green recommends.

Experienced board-certified dermatologist Dr. Michele Green has been masterfully treating patients in her Upper East Side New York City dermatology office for more than 25 years. With her proprietary range of skincare products, MGSKINLABs, Dr. Green is an expert in providing patients with individualized treatment plans tailored to their skin type and aesthetic goals. Whether you are concerned about skin disorders, hyperpigmentation, dark spots, melasma, or signs of the natural aging process, Dr. Green has plenty of treatment options available. In addition to generating individualized skincare plans, Dr. Green has a range of in-office treatments that can help with melasma management and treatment, including chemical peels, mesopeels, microneedling, microdermabrasion, laser treatments, and Cosmelan peels. Well-known for high patient satisfaction, Dr. Green has been voted one of the best dermatologists in New York City by such publications as Castle Connolly, Super Doctors, and New York Magazine.

What is Melasma?

Melasma is a skin condition characterized by areas of pigmentation due to the overproduction of melanin. These blotchy gray or brown patches of discoloration appear most commonly on areas of the face, such as the upper lip, cheeks, bridge of the nose, and forehead. Three main types of melasma exist: epidermal melasma, which is when pigmentation appears on the outer layer of the skin; dermal melasma, which is when the pigmentation is located in the middle layer of the skin (known as the dermal layer); and mixed melasma, which is when the pigmentation is present both in the middle and outer layers of skin.

Melasma occurs when the pigment melanin is overproduced in the melanocytes, which are responsible for producing melanin. When melanin is overproduced, it causes uneven pigmentation across the skin’s surface, resulting in uneven dark patches. The exact cause of the skin condition is not yet known. However, several major risk factors increase the likelihood of developing melasma:

Sun exposure is a significant factor in the development and worsening of melasma. The sun emits several forms of light that can contribute to the condition, including UVA and UVB rays and visible light, such as blue light. Without UVA and UVB protection, these rays of light trigger the overproduction of melanin in the skin, exacerbating melasma and darkening the patches of pigmentation. In fact, sun exposure is the most common trigger for breakouts of melasma, becoming especially prevalent in summer months when patients spend more time in the sun. Understanding the role of sun exposure and sun damage in melasma can empower you to take the necessary steps to protect your skin and prevent flare-ups.

Skin Tone: Patients with darker skin tones—III-VI on the Fitzpatrick scale—are more likely to experience melasma, as there are more active melanocytes in darker skin. Many patients of color do not experience sunburn and, for that reason, do not wear sunscreen. However, sunscreen is very important for skin of color to prevent melasma breakouts.

Hormonal changes and hormonal imbalances: High levels of the hormone estrogen can also contribute to melasma flare-ups, as can thyroid disease. Melasma is particularly common in pregnant women and people—so much so that the skin condition is often referred to as the “Mask of Pregnancy.” However, it is much less common in patients assigned male at birth, as, according to the American Academy of Dermatology, only 10% of melasma patients are male. Birth control pills (contraceptives) containing estrogen and progesterone and hormone replacement therapy may also contribute to melasma flare-ups.

What is the fastest way to cure melasma?

Melasma is a common skin condition that does not have a cure. However, the symptoms of the skin condition can be reduced by decreasing inflammation, eliminating dark spots, and lightening the skin. The best first step in decreasing the appearance of melasma is to consult with an expert, board-certified dermatologist, such as Dr. Michele Green, who will determine which treatment options will be safest and most effective for you. In-office treatments, such as chemical peels, laser therapy, and Cosmelan peels, and prescription medications, such as Tri-Luma, will be the treatment options that reduce the appearance of melasma the fastest. To maintain the treatment results, patients should adopt simple lifestyle changes, such as eating balanced meals, exercising regularly, reducing stress, and practicing strict sun avoidance. A melasma-friendly regular skincare routine will also help to maintain clear, light skin.

What is the best treatment for melasma, according to a board-certified dermatologist?

Melasma cannot be cured, but there are many treatment options to help manage melasma flare-ups and other forms of hyperpigmentation, such as post-inflammatory hyperpigmentation (PIH). The best way to manage the skin condition is to prevent flare-ups by reducing exposure to known triggers, such as sun exposure. To do so, Dr. Green recommends the use of a broad-spectrum SPF 50 sunscreen applied every morning and reapplied throughout the day, especially when spending significant time outside. Some medications can also cause flare-ups to occur, so Dr. Green recommends speaking with your primary care provider to try other medications if that is the case.

When experiencing a melasma flare-up, Dr. Green recommends a combination of skin care products and in-office treatments to reduce the symptoms:

Topical Skin-Lightening Products, such as:

• Hydroquinone cream: a topical cream that can be prescribed to help lighten areas of hyperpigmentation
• Tretinoin (Retin-A): a topical retinoid for skin lightening
• Vitamin-C serum: a powerful antioxidant to address areas of pigmentation
• Glycolic Acid: a chemical exfoliant that helps to boost skin cell turnover
• Corticosteroid cream: a topical treatment with anti-inflammatory properties

With skincare products, Dr. Green may turn to the triple combination approach, which pairs hydroquinone cream with tretinoin (or another vitamin A-based treatment) and corticosteroids.

Tri-Luma Prescription Topical Cream is the only FDA-approved topical treatment option for addressing cases of melasma, which is a skin condition characterized by the appearance of dark spots on the skin’s surface. When applied to the affected areas of the skin, Tri-Luma works as a skin lightener, reducing the appearance of discoloration and inhibiting the further production of melanin in the treated area. Tri-Luma contains three active ingredients—Hydroquinone 4%, the retinoid Tretinoin 0.05%, and the corticosteroid fluocinolone acetonide 0.01%—for controlled skin bleaching, skin cell turnover, and the prevention of inflammation. These powerful active ingredients combined into one cream make Tri-Luma one of the most effective treatment options for controlling melasma.

Chemical Peels can be performed in-office to improve skin tone and texture without the need for significant downtime or the risk of serious side effects. They work by applying a topical chemical solution that reacts with the dead skin cells and debris on the skin’s surface, causing them to slough off and boosting skin cell turnover for clearer, brighter, lighter skin. Dr. Green is an expert in many different types of chemical peels, which have a range of active ingredients to address various skin concerns, but will often turn to the TCA peel for melasma.

Cosmelan Peel: A professional-grade mask applied in-office, the Cosmelan Peel is often Dr. Green’s go-to for melasma treatment. Based on the severity of the pigmentation, skin tone, and skin type, Dr. Green will determine the amount of time needed for the peel to stay on the patient’s face. Patients can then wipe away the mask at home using a gentle cleanser. The resulting skin peeling will help provide patients with smoother, clearer, brighter skin and reduce the appearance of melasma.

What is the best topical treatment to treat melasma?

There are many highly effective topical treatment options available both over-the-counter and by prescription. When looking for over-the-counter products, it is best to find creams that contain ingredients such as azelaic acid, kojic acid, niacinamide, cysteamine, and tranexamic acid. These ingredients work in different ways to inhibit the production of melanin in the body, reducing the appearance of melasma. Topical retinoids are also effective at controlling the symptoms of melasma and brightening the skin by promoting skin cell turnover. Some patients may find that the best solution is hydroquinone-based creams, such as Tri-Luma, which Dr. Green may prescribe for a short period.

Skincare and sun protection for melasma treatment and prevention

Skincare products, such as creams, serums, and sun protection, are highly effective treatments for skin pigmentation conditions like melasma, post-inflammatory hyperpigmentation, rosacea, and dark spots. Skincare products can vary in concentrations to target various aspects of the process of generating excess pigment and aiding in depigmenting the treatment area. Some skincare products, such as glycolic acid, retinoids, and vitamin C, act as pigment correctors by increasing skin cell turnover for more even skin tone and brighter skin. Other skincare products contain ingredients such as tranexamic acid, kojic acid, niacinamide, azelaic acid, and cysteamine, which all work to inhibit the melanin production process to reduce increased skin pigmentation. For the best treatment results, Dr. Green may use a combination approach to melasma treatment.

Wearing sunscreen is perhaps the most important step in managing melasma, as sunscreen can help prevent melasma flare-ups and reduce the severity of the condition. Dr. Green highly recommends that patients add broad-spectrum sunscreen application to their daily skincare routine. In the morning, patients should wash their face with a gentle cleanser, apply a light, hydrating moisturizer, and then a broad-spectrum SPF 50 sunscreen. Even when you are inside, UVA rays can still filter through some windows and cause melasma to flare up, which is why it is imperative to wear sunscreen every day. When patients do spend significant time outside, Dr. Green suggests reapplying sunscreen every two hours to ensure full UVA and UVB protection.

Does aloe vera work for melasma treatment?

Aloe vera can be applied topically to address skin concerns like sunburn, dry skin, and dark spots. The soothing feel of the topical gel can reduce discomfort associated with these skin conditions. Though the effects of aloe vera on melasma treatment have not been extensively studied, some research has demonstrated that it can reduce the appearance of dark spots associated with melasma. Aloe vera is most effective for melasma when applied twice daily.

Can you heal melasma internally?

While topical and in-office treatments are the fastest way to reduce the appearance of melasma, patients can reduce the risk of flare-ups by making lifestyle changes—improving the condition from the inside out. An unhealthy diet, high levels of stress, and lack of sleep can worsen the symptoms of melasma, contributing to inflammation and skin discoloration. By eating a balanced diet, practicing stress reduction, and sleeping for at least seven hours every night, patients can reduce their melasma symptoms internally. Lifestyle changes are necessary for maintaining clear, smooth skin, but most patients will also require topical or in-office treatments for best results.

How do you get rid of melasma from the inside out?

Many patients wonder, “How to cure melasma internally?” Several lifestyle changes can be made to address the underlying causes of melasma, reducing the skin condition from the inside out:

Balance Hormones: Hormone imbalances or fluctuations can contribute to the appearance of melasma on the skin’s surface. These hormone changes can arise due to pregnancy, hormone replacement therapy (HRT), or hormonal contraceptives. The best course of action when experiencing a melasma flare-up due to HRT or birth control pills is to consult with your healthcare provider to determine if there is another option for you. Hormone fluctuations that occur during pregnancy will usually resolve naturally once the baby is born.

Healthy Diet: Eating a balanced, healthy diet can help to improve overall skin health, thyroid problems, and the appearance of melasma. Specifically, patients should increase their intake of fatty acids, leafy greens, water, and nuts like peanuts and walnuts. Reducing alcohol, processed foods, and sugar consumption will also improve overall health.

Stress Reduction: High levels of stress can lead to increased production of cortisol, a hormone that can increase estrogen levels and melanin production. Reducing stress can decrease the risk of developing dark spots associated with melasma on the skin. While reducing stress is often easier said than done, some methods can include regular exercise, meditation, finding work-life balance, leaving time for activities you enjoy, and avoiding overconsumption of alcohol and caffeine.

How to erase melasma naturally

Patients often wonder, “How can I cure melasma from the inside naturally?” While there is no cure for melasma, the symptoms can be reduced through a combination of natural remedies and in-office treatments. Some natural remedies that can help reduce melasma flare-ups include aloe vera, turmeric, consumption of foods rich in antioxidants, stress reduction, and supplements. The best natural solution for melasma is practicing strict sun protection by applying sunscreen with SPF 30 or higher every morning as part of your regular skincare routine.

Does diet treat melasma naturally?

Improving one’s diet can help treat melasma naturally and has many overall health benefits. Patients should begin by reducing their consumption of processed foods, alcoholic beverages, and sugary foods. A balanced diet should also consist of foods high in antioxidants, fatty acids, and vitamin E, including spinach, peanut butter, almonds, sunflower seeds, cabbage, walnuts, and garlic. Drinking plenty of water will also help improve overall health.

Can supplements help treat melasma naturally?

Supplements can also be taken to help treat melasma at home but are most effective when combined with other treatment options, such as topical creams, chemical peels, and laser therapy. Most of the time, supplements taken orally, such as vitamin C, vitamin E, vitamin B12, and vitamin D, can help with inflammation and body regulation but will not have a dramatic effect on the skin. Topical applications of Vitamin C and vitamin A are helpful in reducing the appearance of melasma, as they can help to decrease melanin production, control inflammation, and reduce the effect of sun damage.

How do you treat hyperpigmentation from the inside?

Patients often wonder, “How to treat pigmentation internally.” It is best to address hyperpigmentation with a multi-pronged approach—combining lifestyle changes, such as a balanced diet, hormone regulation, and stress reduction, with topical treatments. Skincare products, such as creams, serums, and sun protection, are highly effective treatments for skin pigmentation conditions like melasma, post-inflammatory hyperpigmentation, rosacea, and sun spots. Skincare products can vary in concentrations to target various aspects of the process of generating excess pigment and aiding in depigmenting the treatment area. Some skincare products, such as glycolic acid, retinoids, and vitamin C, act as pigment correctors by increasing skin cell turnover for more even skin tone and brighter skin. Other skincare products contain ingredients such as tranexamic acid, kojic acid, niacinamide, azelaic acid, and cysteamine, which all work to inhibit the melanin production process to reduce increased skin pigmentation. For the best treatment results, Dr. Green may use a combination approach to melasma treatment.

How to cure melasma from the inside with home remedies / ingredients / food

Patients often ask, “How do you fix melasma on the inside?” While melasma cannot be cured, home remedies, supplements, and a healthy diet can help to reduce the likelihood of a melasma flare-up once the symptoms have been controlled. Melasma is a skin condition that is notoriously difficult to treat, meaning that it is always best to consult with an expert dermatologist, such as Dr. Michele Green, before trying any treatments on your own. Furthermore, home remedies can be a good way to maintain clear skin and reduce the risk of flare-ups, but they are often not fully effective at managing symptoms when they arise. Any natural remedies work best when paired with topical skincare products, prescription creams, and in-office treatments like laser therapy and chemical peels.

How to get started with melasma treatment today

Melasma is a skin condition characterized by uneven brown patches of skin most frequently found on the face, such as above the lip, on the forehead, on the nose, and the cheeks. With melasma so commonly found on the face, a highly visible area of the body, many patients wonder how to reduce the symptoms of the skin condition and prevent flare-ups from occurring. Luckily, many topical creams and solutions can be applied to the treatment area to reduce the appearance of pigmentation, improve skin tone, and create a more even skin texture. However, with a wide variety of treatment options, it can be not easy to know which will be most effective for you. That is why the best first step for treatment is to schedule a consultation with expert dermatologist Dr. Michele Green, who will examine the treatment area and generate a treatment plan that best meets your needs.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing her patients with the best non-invasive treatment options. Dr. Green takes a holistic approach and embraces a less-is-more philosophy, creating customized skincare routines and treatment plans that cater to the unique concerns and aesthetic goals of her patients. She is consistently identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, and Super Doctors for her dedication to her patients and expertise. Please call us at 212-535-3088 or email our New York City-based office today to schedule a consultation with Dr. Michele Green and determine the skincare routine for melasma management that is right for you.