Melasma

[Guide]

Melasma on the face - image courtesy of Wikimedia Commons

Melasma, (aka, chloasma faciei) can co-exist with rosacea. "The symptoms of melasma are dark, irregular well demarcated hyperpigmented macules to patches commonly found on the upper cheek, nose, lips, upper lip, and forehead. These patches often develop gradually over time. Melasma does not cause any other symptoms beyond the cosmetic discoloration. Melasma is also common in pre-menopausal women. It is thought to be enhanced by surges in certain hormones." Wikipedia

Mistca who suffers from rosacea and melasma responded to a post here about what she has done for both conditions which may help you in your quest to find a solution and here are her remarks reproduced from the post: 

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Hi,
I developed melasma due to taking the progesterone only pill. Attempts to treat the melasma with Retin A irritated the hell out of my skin, and led to rosacea, and later on, severe flushing, due to being given ventolin (which I did not need). I also had gut issues and a bunch of other stuff going on at the same time.
Lots of disasters happened to me along the way leading to my current state.

That aside. Melasma. Did you know it is not just a pigment disorder? It actually has a vascular component.
Here is one article which speaks about it.
https://www.mdedge.com/edermatologyn...ponent-melasma

I battled the hideous mess for years and it ruined my life. Trying to treat Rosacea on a background of melasma is a nightmare.

Later on in years, I discovered I was iodine deficient and supplementation finally rid me of the remnants of the pigmentation issue. I do realise it could still be lurking beneath the skin.

In addition, pigment issues are often connected to thyroid dysfunction. I went on to develop Hashimoto's disease during the time I was iodine deficient, but hashi's is a complex disease and has many other contributing factors. 

Currently I am completely free of melasma, but struggle to completely rid myself of rosacea and flushing, although for a couple of years, I was in a pretty decent state. 

Oral and topical niacinamide (which I take/use), are also beneficial for alleviating melasma. Melasma has an oxidative stress factor which the above help alleviate. I take oral vitamin C, but don't use it topically due to irritation.

I also use ZZ cream, which I mix with my niacinamide gel and that helps calm and control my subtype 1 rosacea/flushing. I expect it helps with controlling pigment too.

High dose oral vitamin C, moderate zinc and gut antimicrobials have brought about a reduction of melasma in a number of other women. A quick google should lead you to them. 

Another thing you might consider is elevating your glutathione levels with NAC. Around 200mg. Any more might cause flushing. 
Glutathione is considered a master antioxidant and could help relieve both your melasma and rosacea.

Of course, the above treatments take a fairly long time to work, but I do believe they have merit. I have spent decades researching the subject and applying different methods.

IPL can make melasma much worse and progressive. Been there, done that.

Based on what you say, I suspect you do have a form of rosacea/flushing.

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