I agree with Dandylady on the much of the over the counter products just don't seem to work for Melasma. However, I would greatly caution you against lasers!! Do your research and demand to see before and after pictures for Melasma, NOT sun damage, freckles or age spots--it is NOT the same. I had 4 treatments of Intense Pulse Light/laser or IPL treatments. It made my Melasma WAY WAY worse and I had these weird "lines' down my face. It was horrible, every time I looked in the mirror without makeup, I cried. It sounds stupid, but it really was that bad. I couldn't believe I paid 900.00 for something to make me WORSE.
For all the ladies on this forum, I found something (that for me, will be a last resort) but it is called Melanage Peel. It's a combination of Retin A and Hydroquinone and it is a mask that you put on at the dermatologist's etc. office and you wear it home and depending on your skin type and tone, you leave it on anywhere from 5-10 hours. Bottom line, it is supposed to make your skin peel like crazy, helping peel off the melasma. Do a google search and check out the results. As long as they aren't "doctored up" they are pretty amazing.
As I said, a last resort for me, I have been through enough and what I am doing now is working pretty well.
I posted on the other topics, but will post here too.
I use the clarisonic scrub brush for exfoliating (awesome)
Glycolic toner from Proactiv (since I have oily skin)
MELADERM (a product I found online) not cheap though, but it works. About 80.00, but it lasts for quite awhile
I do all the above in the morning.
At night, same thing (clarisonic with Murad cleanser) and toner
Then I use 4% Hydroquinone (yes it gets a bad rap, but I am only going to use it for the recommended length of time) and I asked my dermatologist and they said women use it year round. That surprised me, but I am only going to use it until the melasma is faded enough for me.
Lastly I take supplements and they help tremendously too. I am convinced it is the combination!
Vitamin C 1000 mg's
MSM 2000-3000 mg's
DIM (not sure on the dosing off my head, sorry)
Zinc 50 mg's
Calcium/potassium/magnesium (combo supplements, again not sure of dosing, just one tab)
Priobiotic (2 tabs/3 times a day) but it depends on the type, some you just take one per day. This helps to remove toxins from the body.
Of course SUNSCREEN (Every single day!) I used the "all natural ones" they are great, but make me look pasty and scary, so I use LA ROCHE-POSAY, you can get online. It's not super greasy and it is supposed to be effective for 5 hours once you put it on. It is SPF 15
I also use Clinique's "almost powder makeup" Also SPF 15 and it has 13% Titanium Dioxide as I have heard it is a natural sunscreen. I have to say this makeup helps to hide the melasma well too. I am 41 and I have literally tried them all and this one works (for me).
This combination has help to undo the damage of the laser and the results have been pretty amazing. It has taken me months though and a lot of hard work, but I am getting there. I hardly have to wear any makeup now, whereas before I was caking it on to hide everything. That's why I am holding off on the Melanage peel since this really is working for me. And my Melasma was pretty severe (well after the IPL) it was moderate prior to that and just spots on each cheek, near my cheek bones.
Good luck, I hope this can help anyone else. Thank you!