This article about melasma is written from personal experience.  I have always been very careful with my skin and have worn sunscreen nearly every day come rain or come shine since I worked at a Clinique counter at the age of 18.  However, one day in my mid-thirties was disastrous for my skin.  I went on a fantastic vacation and was going to swim in the Atlantic.  When I thought I was putting a heavy duty sunscreen onto my face, I was accidentally putting on a plain old moisturizer.  Then I put on my goggles and had a nice swim.  When I got back to my hotel room I couldn’t believe my eyes.  Parts of my skin were suddenly an entirely different color.  I’m a fair blond and found myself with dirty looking, ash colored patches on my forehead, cheeks, nose and upper lip.  In fact, my upper lip looked like I had a moustache.  It was awful!  To top it all off, makeup didn’t cover it up.

As soon as I got home I went to a dermatologist who gave me some fading creams which did next to nothing.  I tried over the counter creams and even tried Fraxel but nothing worked.  I also realized during this time what poor results I was getting from my high SPF sunscreens that I was wearing every day.  I could put on a 50 SPF sunscreen with a hat and go for a half hour bike ride and still see a darkening of the patches.  Even two years after the exposure, people would sometimes ask me if I had just been skiing.  What they were referring to were actually the outlines of my swimming goggles from that day in the ocean which left me with circles of normal colored skin around my eyes.

The reason that I’m writing this is to tell you what finally worked for me.  First, I discovered that the only sunscreen that I could trust was the range of Neutrogena products with Helioplex.  They’re not a melasma treatment, but they kept the marks from getting any darker.  They come in several versions and although some have SPFs above 100, I like the texture of the lower ones personally and they seem to get the job done.  I'll use a more heavy duty one though if I know I'm going to be outside for a while.  Be careful not to just buy any Neutrogena sunscreen.  If it doesn’t say Helioplex, it doesn’t have Helioplex.  The second major discovery was a dermatologist who offers a combination of microdermabrasion immediately followed by IPL (Intense Pulsed Light).  I had tried both treatments separately in the past without much effect, but the two together seemed to be the miracle that my skin needed.

There was a noticeable difference at the end of the very first treatment.  The microdermabrasion was completely painless.  It felt like a stream of tiny grains was being shot at my skin, sloughing off the outer layer.  It was even quite pleasant.  The IPL was done after a numbing cream had been applied to my face.  A wand was held over a certain spot on my skin and light would shoot out for a fraction of a second.  Then the wand was moved to an adjacent area.  I felt a tiny sting but not so much that it hurt on most of my face.  However, when it gets to the area around the edges of your nose, it stings more.  That area made my eyes water from the sensation but nothing worse.  Out of the 15 or 20 minutes the IPL lasted, only 2 or 3 of them hurt.

The big plusses are that the effects are immediate.  Even when you’re a bit red from the treatment, you can look in the mirror and see the difference immediately.  I couldn’t believe my eyes after having been told years before that I had the very deep kind of melasma that would be very hard, if not impossible, to treat.  The other plus is that there is no downtime.  I went back to work the next day without a thought to covering my face.  In fact, I was thrilled to have a more even skin tone after my years of hyperpigmentation.  What I do now for my morning makeup routine is to take one of my Neutrogena sunscreens, squirt a quarter size blob in my hand and then mix in a few drops of my regular foundation.  I mix it in my hand and they apply it all over my face.  Any extra goes on my neck.

I have since gone back for another treatment where I saw much more improvement.  I really should go back for a third but at $500 for each session of microdermabrasion and IPL combined, I have been putting it off.  Also, although I can still see a few marks if I look closely, I feel like my melasma is more or less gone.  I can’t say that this will work for everyone, but if you have this problem and are at the point of giving up hope, I would definitely recommend giving this melasma treatment a try.  It changed my life for the better. 

Neutrogena Ultra Sheer Dry-Touch Sunblock, SPF 30, 3 Fluid Ounce (88 ml)
Amazon Price: $10.15 $7.18 Buy Now
(price as of Jun 20, 2014)
My own personal favorite everyday sunscreen
Neutrogena Age Shield Face Lotion Sunscreen Broad Spectrum SPF 110, 3.0 FL OZ
Amazon Price: $12.99 $9.50 Buy Now
(price as of Jun 20, 2014)
My sunscreen for 'heavy sun' days