Derm Topics

Patient Buzz: Melasma Moustache | The Expert Weighs In

Good Housekeeping recently posted an article on how to treat a melasma moustache. What should dermatology clinicians know about treating melasma on the upper lip? What are some up and coming melasma treatments that dermatology clinicians should be aware of?

For expert advice, I reached out to Jennifer Rullan, MD, FAAD, a dermatologist in Chula Vista, Ca.

How common is melasma on the upper lip, and what causes it?  

Melasma of the upper lip is very common, especially in patients who play outdoor sports in warm climates. The cause can be hormonal, or heat and sun, and oftentimes all three factors are at work.  

What should dermatology clinicians know about treating melasma on the upper lip specifically? Are there any special precautions that dermatologists should take?

Melasma of the upper lip is challenging to treat due to its resistance and due to the sensitive skin of that location. The delicate skin of the upper lip can get irritated with

hydroquinone 2-4% or retinoids. I usually use these products every other day combined with a non-steroidal anti-inflammatory, such as tacrolimus, to avoid irritation.

What are some tried and true melasma treatments that dermatology clinicians should still consider using today?

Topical botanical brighteners and oral tranexamic acid pills are well tolerated and effective melasma treatments.

What are some up and coming treatments that dermatology clinicians should be aware of?

Superficial peels with mandelic acid 30-45% — alone or with salicylic acid 10-20% — given in two to four sessions can help speed up results of melasma treatment.

What do you tell your melasma patients about steps they can take to minimize their melasma and prevent reoccurrence? 

I tell my melasma patients to protect their skin from the sun and heat. I advise them to take oral polypodium leucotomos and wear tinted zinc oxide-based sunscreens. In addition, I recommend they keep their face as cool as possible, such as having air vents directed to blow on air conditioning on the face while driving in a car.

What else should dermatology clinicians know about treating melasma?

It’s important to provide counseling to patients and to understand the patient’s lifestyle when creating an effective regimen. Melasma skin care regimens should also change as the seasons change because our skin changes with the seasons.

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