My Melasma Journey – 1-Year Update

About a year ago, I wrote a blog post about the start of my melasma journey with the intention of putting all the thoughts that were swirling in my head onto virtual paper and sharing my experience publicly with others who may be experiencing melasma too. Today I want to give an update on the events of the past year including what I’ve tried to treat my melasma, what has and hasn’t worked, and my thoughts on the whole experience.

If you’d like to know about the start of my journey including basic information about melasma and the first things I tried, you can read all of that in this blog post.

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What I’ve tried over the past year

1. Musely

When I wrote my first blog post a year ago, I had just started using the Eucerin anti-pigment line and had high hopes that it would work. It didn’t work for me at all, so I moved on to Musely. I’d seen the ads online and read the reviews of some people having amazing results with Musely. I was ready to give it a try.

I used The Spot Cream, which comes in four different formulas. Which formula you get depends on what the dermatologist prescribes to you based on your history and preference. 

I started with the Nurture formula. This consists of

• Hydroquinone 6%
• Vitamin C 1%
• Niacinamide 2%

I was prescribed this because I had used 4% hydroquinone in the past with no change. I used this for 3 months and found I had the most benefit from this versus anything else I had tried in the past.

My spots became lighter, although not drastically so, and they didn’t go away completely. I would estimate that they lightened about 25% to 50% depending on the day and the spot. Some days my spots were minimally visible with a light layer of makeup. 

I was happy to have finally found something that worked! 

I was a little nervous about using hydroquinone at such a high percentage. I had read that you should not use hydroquinone for too long, no more than 3 to 5 months at a time, as it can have the opposite effect with overuse. Your skin can darken permanently due to a rebound effect.

I didn’t encounter the spots darkening, but after 3 months, I was concerned that the areas around my dark spots were lightening as well. It’s hard to get the perfect balance!

I didn’t want to add more irreversible contrast to my face. At that point, I switched to the HQ Free formula, which consists of

• Tranexamic Acid 6%
• Azelaic Acid 10%
• Niacinamide 2%

I’ve been using the HQ Free formula since then. It’s been about six months now and I haven’t seen any further improvement. It’s possible that the HQ Free formula is staving off a return of the darkening, but it hasn’t made anything noticeably lighter. 

The Spot Pill

I started taking The Spot Pill by Musely almost two months ago. The Spot Pill consists of

• Tranexamic Acid 225mg

Oral tranexamic acid works to block excess melanin production leading to fading of dark spots. This is considered one of the more effective solutions to melasma, although it is often prescribed for more severe cases because of the possibility of side effects like increased risk of blood clots.

I’ve been taking it twice a day, so 550mg total. I haven’t seen any change, but it can take 3 months to see any results. 

After I finish the first set of pills, I think the prescription goes to taking it once a day. I wonder about the effectiveness of the pill at that point because it’s a relatively low dose. I will ask the dermatologist and reevaluate if I want to continue the pills at that point. 

2. Tretinoin

My in-person dermatologist (as opposed to the virtual one from Musely) prescribed tretinoin to help with skin turnover. I’ve been using this to supplement the other measures I’ve been taking. 

My impression is that tretinoin by itself is not enough to fight melasma. I have heard of some people getting rid of their dark spots using only tretinoin, most people will need more than just that. 

3. Sunscreen

I’m religious about using sunscreen. After trying several sunscreens over the past year, I’ve settled on these:

• La Roche-Posay Anthelios UVmune 400 Invisible Fluid SPF50+
• Elta MD UV Clear Broad Spectrum SPF 46 (tinted and non-tinted)
• Australian Gold Botanical SPF 50 Tinted Sunscreen (this comes in three shades)
• Bondi Sands SPF 30 sunscreen lotion

The La Roche Posay is a staple that I use every day. The Australian Gold sunscreen is very thick, so I apply it only 1-2x per day. I use the Bondi Sands sunscreen on other parts of the body like the ears, neck, chest, hands, and feet.

4. Sun protection

I use sun protection every time I go outside. I start my day with Heliocare pills, which are a natural supplement to fight free radicals in the body. I’ve heard people say it’s like internal sunscreen. 

You still have to wear sunscreen and take other measures as well. In addition to sunscreen, I wear

• a wide-brim hat
• sunglasses
• a UV mask

It doesn’t get too hot where I live, even in the summer, so I can wear these things without feeling overly hot on most days. 

My Plan

I’m going to stick with Musely for the time being. My plan is to use Musely’s HQ Free formula for another 3 months or so for about 9 months in total. 

I don’t want to switch back to a formula with hydroquinone just yet. I have to avoid the sun as much as possible while using hydroquinone because the skin becomes very photosensitive during its use.

I’m getting more sun just by it being spring right now, and summer is coming. I’ll wait until the fall or winter to start the Nurture formula with hydroquinone again. 

I don’t know whether or not I will continue The Spot Pill. I might continue it for about 6 months in total. If doesn’t work for me after that, I may give it up, especially since it has the potential for negative side effects.

While I have my opinions and preferences about things, I’m doing all of this in consultation with the Musely dermatologist. I will check with him or her before making any major changes.

My skincare routine

After trying many products and dealing with skin outbreaks, I’ve settled on a skincare routine that works for me. Although the following seems like a lot of products and a lot of work to put on, I vary their use a bit and don’t use all of them every day so it’s manageable. 

Morning

1. Clean & Clear daily pore cleanser

I like this cleanser because it’s extremely gentle on the skin. It has microscrubbers, but I don’t feel them at all. I’ve never had a problem using this even when my skin was acting up because of other products.

2. Eucerin anti-pigment face day cream 

While the Eucerin anti-pigment line products did not work for me, I still have several of the products open and half used. I decided to keep using them only putting them on the dark spots until I finish the products. I put a light layer on the spots on most days, not every day.

I checked with the dermatologist from Musely who said it was okay to continue using the Eucerin line and really any other product simultaneously with Musely as long as the products didn’t irritate my skin.

3. Kiehl’s Ultra Facial Cream SPF 30

I use Kiehl’s Ultra Facial Cream all over my face, neck, and ears. It’s lightweight, non-greasy, and makes a good base for my makeup. It is a chemical sunscreen because of its ingredients: avobenzone (3%), homosalate (5%), octisalate (5%), and octocrylene (7%).

There’s a debate about whether to use chemical or mineral sunscreens or if they can or should both be used. I use them both with the chemical sunscreen below the mineral one, making sure to give the chemical one time to dry and be absorbed first. 

4. Colorescience Sunforgettable® Total Protection™ Face Shield Glow SPF 50

I’ve read that this Colorescience product does not have the strongest persistent pigment darkening (PPD) rating. Persistent pigment darkening is a method of measuring UVA protection that’s similar to SPF. 

I use a small bit of this over the Kiehl’s to give a bit more sun protection, but I don’t depend on it to be my main source of sun protection because of its use of chemical ingredients and lower PPD rating. 

I primarily use this on weekdays to add color to my face. It’s lightweight and translucent and gives the skin a nice pearlescent illuminating glow. I don’t use it on the weekends.

5. La Roche-Posay Anthelios UVmune 400 Invisible Fluid SPF50+

This La Roche-Posay sunscreen is my favorite for its extremely lightweight quality (feels invisible!) and long-lasting very high UVA and UVB protection. I’ll put it on once everything else has dried, sometimes over my makeup and sometimes under my makeup. 

I don’t feel the number of products or types of products I use to leave my face feeling heavy or cakey. I wear minimal actual makeup, just some light concealer and powder foundation. 

Once I run out of the Eucerin and Colorescience items, I will stop using them altogether because I have found other products that work better for me.

Evening routine

1. DHC Deep Cleansing Oil

This DHC cleansing oil is a godsend! When I started using tons of sunscreen throughout the day and trying out various sunscreens, my face would be covered in products by the end of the day. I had such a hard time washing it off because sunscreen is often water-resistant. 

After some skin breakouts, I tried several makeup removers and found the DHC Deep Cleansing Oil to be the most effective and gentlest. It’s like rubbing olive oil all over your skin. 

It washes off easily too when I hop in the shower or go on to the next step of my routine. It was softer than using makeup-removing towelettes, cotton pads with micellar water, or anything else I had to wipe on and off my face. 

It even comes in a small travel size that lasts weeks. I can’t say enough about how much this has helped me clean my skin!

2. Clean & Clear daily pore cleanser

Cleaning my face in the evening is now two parts. The first is removing the sunscreen I have on my face with the DHC Deep Cleansing Oil. The second is using my original face wash, the Clean & Clear daily pore cleanser.

Once in a while I will vary this with a St. Ives face scrub if I want a little more exfoliation.

3. Musely

I’m currently using Musely’s The Spot Cream for melasma. I used the Nuture formula with hydroquinone for about 3 months before switching over to the HQ Free+ formula that does not have hydroquinone. I’ve been using the HQ Free+ formula for about 6 months now. 

I use a small amount only on the dark spots. I put it on and wait for it to dry before going to bed. Some people put it on right before bed, but I think the product ends up on the pillowcase rather than being absorbed. 

4. Tretinoin

I use tretinoin in 0.025% or 0.05% strength about 4 to 5 times per week. I put a light layer on any problematic areas, not only dark spots. Tretinoin is used for acne and anti-aging as well.

If I use too much or use it too frequently, my face will be sensitive in those spots the next day. I take a break for a few days and use it again when my face feels back to normal.

5. Moisturizer

Musely and tretinoin can cause dry skin, so using moisturizer consistently is essential. I wait a while after using the above products to give them time to dry. Then I put on a thick layer of moisturizer.

These are my favorites:

• Kiehl’s Ultra Facial Cream (without sunscreen)
• Cosrx Advanced Snail 96 Mucin Power Essence
• Cerave

I sometimes do other activities between each of these products to give time for each one to absorb or dry. For example, I’ll use the cleansing oil before hopping into the shower, Musely after the shower, tretinoin while brushing my teeth, and moisturizer before bed. 

It seems like a lot but goes quickly and mindlessly once you get used to the routine.

My thoughts 

1. I’m more accepting of my melasma.

I’ve had this for over a year or two now. Initially, I was worried about it spreading like wildfire. It hasn’t gone away as I had hoped, but it hasn’t spread or darkened much either.

My skin is stubborn and it seems no matter what I do, the melasma doesn’t budge. I think I may just have to live with it for the rest of my life, although I won’t stop trying to manage it and prevent it from spreading. 

I’m more accepting of it now. Sometimes I struggle with it, and at other times I forget that it’s there. 

The issue is cosmetic, so it hasn’t affected my health in any way. It hasn’t prevented me from getting to know people or doing the things I want to do. 

No one has commented on it, even on days when I don’t wear makeup. My husband doesn’t care about it and thinks I spend too much time and energy thinking about it. 

2. I can still live my life.

While I’ve never been into spending lots of time out in the sun like sunbathing or vacationing in hot climates, I would still get a fair amount of sun in my daily life. It’s hard to avoid when you’re in the car, while walking the dog, or just doing errands outdoors. 

I still do all of those things, just now with more sun protection. I went to Las Vegas, where the sun is strong. I used a hat and sunglasses. I put on sunscreen and stayed in the shade by the pool. 

My melasma didn’t get worse, and I enjoyed my vacation. I can still live my life and do the things I enjoy while managing my melasma.

Wrap Up

I wish I could say that now, after having fought my melasma for more than a year, I’ve found something that works for me. I wish I could say that my melasma is gone, and these were the products and the routine that worked for me. Why don’t you try them too? 

Unfortunately, that’s not the case. My melasma persists, mostly unchanged, as it does for so many people. 

I posted an update to my melasma journey to share how things have been going for me over the past year.

If you have thoughts on any of the above or want to share your experience, I’d love to hear in the comments. I wish the best for you too!