Sometimes melasma fades on its own, although this may take several months. There are a number of treatments for melasma, but the results vary based on the type of melasma you have. Epidermal melasma is easily treatable, but dermal melasma often proves difficult to get rid of, because it comes back with continued exposure to the sun.
A dermatologist can diagnose you with melasma based on the appearance of your skin, and there are many different creams that he or she can prescribe to reduce the condition's appearance. Creams with the active ingredient hydroquinone, which is a skin-lightening agent, are effective about 30 percent of the time [source: DermNet New Zealand]. Creams that contain active ingredients such as tretinoin, corticosteroids and azelaic acid can also be effective, because they combine with the hydroquinone to enhance its effects [source: Merck]. You should call a dermatologist if your skin becomes irritated after using any of these creams.
If creams don't work for you, there are more advanced treatments that you can ask your doctor about. Chemical peels, microdermabrasion and laser surgery have all been used to treat melasma, and though their effects are somewhat unpredictable, there's a chance they'll work faster than topical creams [source: Montemorano]. These three procedures, however, must be approved by your physician and tailored to your specific skin type, as well as the type of melasma that you have.
In addition to these procedures, another technique called intense pulsed light therapy can remove the pigmented layer of skin by using light energy. But this treatment is not as common, so you'll have to do your research and find an expert before going down that path.
If you have melasma, you probably want to keep it from spreading. Read on to find out if this is possible.