PSA - Accidentally resolved my melasma (although in the worst way possible!)
TLDR: I wrecked my skin barrier using too many actives to try to reduce my melasma, and when I emerged from the wreckage, my melasma was nearly gone. Moral: sometimes the actives are the problem.
Long version:
I've been struggling with melasma on my forehead and cheeks for about a year, which was triggered by using estrogen cream on my neck for a couple months. I tried Eucerin thiamidol, Coleman compound, and azelaic acid.
Because my skin can handle a lot, I didn't really notice that I was slowly eroding my skin barrier. The only sign was that my cheeks started being more flushed, and would turn red in heat much more than they ever used to. I thought I had developed type 1 rosacea, and doubled down on the azelaic acid.
Fast forward to three weeks ago, and all of a sudden my face was stinging, red, and popping up in a bumpy, strange texture that I had never seen before. Any time I went outdoors my skin would sting and swell and turn bright red. It was absolutely horrendous.
I realized I'd destroyed my skin barrier, and went into full on repair mode. No actives, no washing, just a cool water rinse, milky toner, ceramide and cholesterol cream, Cicaplast, and a thick layer of zinc-based diaper cream at night. I stayed out of the sun and indoors for almost a week (I actually got sick, which helped). It was horrible, and my skin felt awful, but I fully committed to doing whatever I could to turn it around.
I also avoided spicy foods, hot beverages, and anything that might cause flushing.
About three days ago, I emerged from the mime mask of diaper cream that I've been wearing nonstop, and actually looked at my skin for the first time.
I realized that weirdly, my melasma was almost completely....gone?
My skin now actually looks like I did some sort of laser resurfacing treatment, it is soft, smooth, even textured, and very even-toned.
It's been a horrible experience overall, and I would NEVER recommend destroying your skin barrier to rehab your skin. I will need to stay out of the sun and baby the shit out of my skin for another month at least, but weirdly, this trauma has somehow resolved my melasma.
So the lesson learned is that sometimes the best solution is to keep things as hydrating and moisturizing and simple as possible, and actually avoid all the pigment inhibitors and exfoliants that are meant to reduce melasma.
Obviously, everyone's skin is different, but I do think that for me, hydration and moisture (and avoiding the sun) have made the biggest difference.
The crazy thing is, though, that I have always been insanely diligent about sun protection (European filters, constant reapplication, hats, sunglasses, etc) as well as layers and layers of hydration and moisture.
And the one thing that seemed to make my skin perfect has been laying off all the actives.
So, just wanted to share this story for anyone who may benefit from my mistakes. If you're using a bunch of pigment inhibitors and nothing is working, it could be worth a try to stop them all, and just give your skin some breathing room to do it's thing.
I am honestly shocked at this outcome, but I'll take whatever silver lining I can from this (self-imposed) trauma!