The Best Skin Lightening Cream For Melasma

If you’ve been dealing with dark patches on your skin for a while now, you might be wondering what’s the best skin lightening cream for melasma. Today, we discuss the top products to improve your melasma.

Learn more:

• What exactly causes melasma?
• Can you prevent melasma?

What Are The Best Skin Lightening Creams For Melasma?

There are countless products to choose from to treat your melasma. Here’s our choice of five creams to lighten melasma on the face:

Skin lightening cream by Eva Naturals

Described as a powerful formula with naturally effective ingredients, this affordable melasma cream might be the solution you’re looking for. It has all the ingredients to help you deal with those dark patches of skin from kojic acid and vitamin E to coconut oil and vitamin B. All of them combined create a lightweight formula that is safe for all skin types. It’s one of the best creams to lighten melasma on the face, but also promotes collagen production for firmer, smoother skin all around.

Dark spot corrector cream for the face by PurePeaks

PurePeaks combines natural ingredients with science to create a mix that’s quite successful in dealing with dark spots and melasma. Their main ingredient is alpha arbutin, a melanin inhibitor that’s an alternative to the standard hydroquinone. Combined with niacinamide, this formula is considered as one of the best melasma creams for the face. It also contains aloe vera and licorice and mulberry extract for additional skin moisturizing. This cream is mid-range in price and can be an ideal option for people with sensitivity to hydroquinone.

SkinMedica Lytera 2.0 pigment correcting serum

Lytera is an advanced formula for treating dark spots on the face, including melasma. It’s retinol-free and paraben-free and is a non-comedogenic formula that has antioxidants that are effective in treating discoloration on the skin. This product is on the high end of the price spectrum, but it has a lot of positive reviews and happy patients.

Pigmentclar by La Roche-Posay

Created for sensitive skin, Pigmentclar by La Roche Posay contains a formula effective for fighting dark spots. It contains phe-resorcinol, ferulic acid, and micro-exfoliating lipo-hydroxy acid, all of which work to combat skin discoloration. This formula also contains ingredients that help your skin naturally appear more radiant and bright.

Glytone dark spot corrector

Based on hydroquinone, kojic acid, and glycolic acid, this cost-effective formula is one of the best skin lightening creams for melasma. The kojic acid works as an exfoliant while the hydroquinone helps prevent further skin discoloration. It’s important to remember that you should only apply this product to the dark spots on your skin, not to your entire face.

How Do Topical Creams For Melasma Work?

As you may know, melasma is a skin condition that’s caused by increased melanin production which results in dark patches on the surface of the skin. These patches may develop on the forehead, the cheeks, or the nose, but can also appear on the neck and the forearms.

Melasma creams aim to lighten the skin in a variety of ways, such as reducing melanin production, blocking pigment formation, encouraging cell turnover, or physically removing the dark patches. Topical treatments are many dermatologists’ first choice for treating melasma because of the minimal side effects and well-documented track records of the ingredients in these formulations.

Melasma creams are most effective in the epidermal type of melasma, the type that affects the top layer of the skin. These products can be used on their own or in combination with others, depending on skin sensitivity, skin type, and the type of melasma (Bandyopadhyay).

Some of the most common topical ingredients in skin lightening creams for melasma include:

Hydroquinone

The first topical medication often available in cream form that is worth exploring is hydroquinone. Study after study has conclusively shown that this medication is demonstrably effective in the treatment of melasma; it is among the melasma creams that work (Monteiro).

There are some marginal concerns related to the potential side effects of hydroquinone cream for melasma, such as:

• Mild inflammation
• Redness
• Dryness

However, hydroquinone is a potent tool with which to fight against melasma, and it can be used safely, especially under the supervision of a skin care professional who can guide you through your fight against melasma. They will be able to provide you with a melasma cream prescription that will get to work on clearing up your hyperpigmentation quickly. Your dermatologist will know when it is appropriate to modulate the strength of the cream as needed.

Azelaic Acid

Another potent tool to lighten your complexion and deal with persistent melasma is azelaic acid. Although essentially every melasma medication available, cream or otherwise, has not been studied as scrupulously as hydroquinone, there is good clinical evidence to support the efficacy of newer medications like azelaic acid (Sarkar).

Azelaic acid is a naturally occurring compound produced from yeast. It has been available in the US since its approval by the FDA in 2015. Azelaic acid works by affecting melanin synthesis (Abdel). It has the added benefit of working as an antimicrobial agent and therefore has multiple uses that extend beyond treating hyperpigmentation.

Several studies of azelaic acid have corroborated its status as a known skin-lightening agent (Sarma et al). In fact, studies have shown efficacy similar to that of the well-established hydroquinone.

Because azelaic acid cream for melasma will thin your skin, its use is associated with higher sensitivity to UV radiation, so liberal broad-spectrum sunscreen use is recommended. Other side effects might include a slight stinging sensation or dryness, both of which indicate that your medication is working.

Triple Cream

By now, anyone who has melasma is likely acutely aware of how difficult it is to treat this condition. Unfortunately, despite several medications exhibiting evidence of efficacy, no single medication or treatment has ever risen as the definitive answer to melasma (Sarma et al.).

As a result, the approach to melasma will often involve combination therapy, and topical treatment will often consist of the use of multiple melasma-fighting agents at once.

This so-called triple cream for melasma, similar to the ones here at Kirsch Dermatology, will blend several of the most effective creams, especially ones that have been shown to work well in conjunction with each other.

One of these combinations is hydroquinone with fluocinolone acetonide and tretinoin. This particular combination of medication has been shown to work well, even better than the “gold standard” melasma treatment hydroquinone when used as monotherapy (Chan). The idea in using all three in conjunction is simple: the tretinoin works to promote cell turnover of the outer layer of skin to allow the bleaching agent, hydroquinone, to penetrate more deeply into the skin. And because some amount of inflammation is endemic to hydroquinone’s mechanism of action, a corticosteroid like fluocinolone acetonide is used to mitigate some of that inflammation.

Note that some of these adjunct medications work best synergistically with other medications. For example, monotherapy in the form of tretinoin cream for melasma is not optimal (Sarma et al.).

Silymarin

Beyond the aforementioned chemicals, there are still other topical agents that are sold as skin lighteners and depigmentation agents. Some of these are plant extracts like silymarin, more commonly known as milk thistle.

While not as effective when used as monotherapy, silymarin cream for melasma can work as ancillary medication to more standard treatment. Many of these natural extracts are powerful antioxidants which can treat melasma as well as some of the side effects associated with bleaching products like hydroquinone (Karimi). Silymarin is not known to be toxic to humans, but like all medications, it does carry some risk for an allergic reaction.

Pycnogenol

Similarly to silymarin, pycnogenol cream for melasma is an antioxidant that can decrease inflammation and prevent cell damage. In the one study done to determine its effect on melasma, patients did exhibit less hyperpigmentation than their control group (Muhammad). More research will need to be carried out before pycnogenol can be corroborated as an effective melasma treatment.

Tretinoin

Tretinoin is used in the treatment of melasma; however, it is typically used as an adjunct melasma treatment and is not recommended as monotherapy (Sarma et al.). Tretinoin does not directly bleach skin in the same way that a hydroquinone based topical treatment would. It helps to promote cell turnover and is therefore effective in combination with bleaching agents to allow medications to penetrate more deeply into the skin.

Like almost any medication, there are some side-effects associated with tretinoin:

• Increase skin sensitivity
• Mild irritation
• Skin dryness
• Increases your sensitivity to UV rays

Therefore, liberal sunscreen use is recommended alongside application of tretinoin.

Kojic Acid

Kojic acid is a byproduct of fungi with a variety of medicinal and commercial applications. It is a known depigmentation agent (Desai). It works through its ability to regulate tyrosinase and therefore melanin production.

The primary side effect of kojic acid is that it can contribute to dermatitis in some patients (Nakagawa). It is also associated with heightened skin sensitivity that is characteristic of most topical treatments which bleach the skin in some form.

It’s important to remember that regardless of what type of treatment you choose, melasma is often slow to show improvements. However, with patience and the diligent use of a UV-protective skincare routine, treatments can help you even out your skin tone, brighten your complexion, and get healthier-looking skin (Palmer).

References

• Arora P, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. Journal of cutaneous and aesthetic surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461803/.
• Bandyopadhyay D. Topical treatment of melasma. Indian journal of dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807702.
• Melasma. British Skin Foundation. https://www.britishskinfoundation.org.uk/melasma.
• Melasma: Diagnosis and treatment. American Academy of Dermatology. https://www.aad.org/public/diseases/a-z/melasma-treatment.
• Sarkar, R., Bansal, S., & Garg, V. K. (2012, October). Chemical peels for melasma in dark-skinned patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560164/
• Topical retinoids. Topical retinoids | DermNet NZ. https://dermnetnz.org/topics/topical-retinoids/.
• Trivedi MK, Yang FC, Cho BK. A review of laser and light therapy in melasma. International journal of women’s dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418955/

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Brandon Kirsch, MD

Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the Naples Community Hospital.