Melasma?--whats the quickest, best treatment??

I have Melasma on my upper lip (looks like a shadowy mustache) and above both eyebrows.  What is the best and quickest treatment to get rid of it?  I have just gotten a prescription for Tri Lumina, but it says it can take months to work.  What about laser treatments?  Does anyone know if they are successful?  

Second question is, what causes it?  I have read birth control pills, Im not on, and pregnancy, Im not that either.  Any other cuases?

[Guinness1]

Melasma is hormonal, and in pregancy is often called ,'the maskof pregnacy'. I have had this condition for years.  keeping out of the sumlight does help,(I wear my big rimmed hat even today.  My dermy prescribed a bleaching lotion,  it worked really well and I honestly think this is the  only way to attack this condition externally, unless you can afford laser,(Iv'e never looked into that, and my doc never has suggested it.) Expect peeling dry skin.  I had a friend try Tri Lumina and I thought the results were amazing. I once thought that I was doomed for the rest of my life with this condition.  But, I am happy to say that there is an answer.  Get yourself a good understanding doc.

[BhumikaMD]

Hi,

The treatment options available are -
'Topical depigmenting agents, such as hydroquinone (HQ) either in over-the-counter (2%) or prescription (4%) strength. HQ is a chemical that inhibits tyrosinase, an enzyme involved in the production of melanin.

Tretinoin, an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy.

Azelaic acid (20%), thought to decrease the activity of melanocytes.

Facial peel with alpha hydroxyacids or chemical peels with glycolic acid.'

'Laser treatment for melasma - A Wood's lamp test should be used to determine whether the melasma is epidermal or dermal. If the melasma is dermal, laser (or "IPL") will actually DARKEN and worsen the appearance of the spots. Dermal melasma is generally unresponsive to most treatments, and has only been found to lighten with products containing mandelic acid.

In all treatments for melasma the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc dioxide is preferred over that with only chemical blockers. This is because UV-A, UV-B and visible lights are all capable of stimulating pigment production.'

You should consult your doctor about this and whether laser treatment would help in your case.

You could read more about this at the following links -

http://en.wikipedia.org/wiki/Melasma

and

http://www.emedicine.com/DERM/topic260.htm

Let us know if you need any further information.

Regards.