I am 41 with melasama (tried IPL treatments) do NOT recommend, it made it worse in my opinion. I was on the birth control pill 10 years ago and I do think that it may have something to do with it. My mother had melasma, so I also think it runs in families (unfortunately). I do not think you can ever really go back out in the sun without a very potent sunscreen and hat. The sun just makes it worse and undoes all that you are trying to do to get rid of it. The sun is the main thing that always made my much much worse! I tried a artificial tanning product called "Glofusion" if put on properly, it gives you great color and looks very natural.
I have tried many many sunscreens, but a lot of them make you look scary white! Does anyone have a suggestion on a natural sunscreen that does not make you look half dead? LOL
I am currently using LA ROCHE-POSAY SPF15 Daily moisturizer and I have oily skin and it seems to work fairly well. It is supposed to last for 5 hours from the time you put it on in the morning. Remember, sunscreens do not last all day, you have to re apply at some point during the day.
I just purchased an SPF 60 Ti-SILC from the Dermadoctor.com It is tinted, but I have not tried it yet (quite frankly I am afraid) LOL They always make you looks so WHITE! It has 7.0 Titanium Oxide, Green tea, sunflower oil and several other ingredients, but supposed to be more natural.
Lastly I use a product called MELADERM for my melasma. I think it has been close to 1 month and I really am seeing improvement. I was just about to give up! I don't know if I have epidermal or dermal melasma yet? I exfoliate my face well (clarisonic works great for me!) and then use a glycolic acid toner from Proactiv and then put on the meladerm (you have to wear it morning and night). It seems to be "breaking up" the melasma and making it into more smaller patches than one big large patch. The company says it can take up to 3 months. It is all natural ingredients, no hydroquinone.
I have also heard of a treatment called Melanage Peel. I posted something on one of these sites and someone told me about it. That will be my last resort I think. It is supposed to be some sort of mask (Retin A and Hydroquinone) that the derm puts on you and you leave with the mask on and your skin peels and lightens. I have seen pretty dramatic results online, just do a google search. Apparently it replaced some other treatment that was discontinued in 2007. It appears to be pretty expensive about 800 for the treatment. It seems to work pretty well from what I have seen online. But wonder what side effects if any?
I am going to continue with my current regimen and continue using Meladerm for now. Wear a good sunscreen daily, avoid the sun as much as possible and take vitamins and supplements that enhance the skin natural defenses. I have also read that unsweetened soy milk can help with dark spots too? I have not tried, nor do I know anyone that has.
Just be patient, it takes a ton of time to improve the skin, but I think it can be done once you find what really works best for you. Every person is different. I have olive skin tone, oily and sensitive skin and all of these products are working for me. I will post after another month or so on the Meladerm and let you know if it works. It is not cheap either, about 80 for the larger size bottle, but it has been a month and I still have quite a bit left.
One last thing, makeup that is a great cover up and all natural with A,C, E vitamins is GLOMINERALS. I love it! Again, not super cheap, but your face is worth it! It has a natural sunscreen as well, great coverage and actually improves my skin overall.
Good Luck everyone! Sorry for the "book" but I want to help anyone that I can. Melasma sucks! LOL
Take care!!