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Melasma got worse after laser treatment. Using various creams, problem persists. Solution?

Hi Dear DR,I am 52 year old my melasma after laser get worse and now i am use hydroquinone ,koiic Acid,Tretinoin Betamethasone ,aqeuous cream .My face get light but i can see the patch still on my face,theses hydroquinone cant lighter complate with melasma but only can tell my skin get to much white and the melasma destn t complate gone..what can i do it very worried my lot,Dr can you help me please.
Asked On : Sun, 16 Dec 2012
Answers:  1 Views:  127
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General & Family Physician 's  Response
I understand your concern and really feel sorry for you.
Management of melasma can be challenging and requires long-term treatment with topical agents. The results are often unsatisfactory and topical agents may sometimes cause significant adverse reactions. 
Hydroquinone has remained the gold standard of topical treatment but concerns regarding its side effects remain. A triple combination of hydroquinone, retinoic acid, and corticosteroids has been suggested to be the first-line topical treatment for this pigmentary disorder and incidentally you ate undergoing the same triple combination treatment.
 Many new agents that inhibit melanogenesis have been developed but they are not proving to be totally successful.
I would advise you to continue your treatment.
Answered: Sun, 16 Dec 2012
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