Hello,
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I read your query and understand your concern.
The Cysteamine cream (Cysteamine Hydrochloride) that you are using currently is a great treatment for reducing the appearance of hyperpigmentation which is caused due to melasma. Tranexamic acid tablets are also used for melasma. However, there are so many other alternative procedures as well as medications that can be used to reduce the chances and the appearance of melasma. Therefore I would like to advise you to try other procedures and treatments which are available as well. Melasma is a skin condition resulting from multiple reasons, including genetic susceptibility, wherein a similar condition runs within the family and may be transmitted genetically. In addition, they may be caused due to hormonal fluctuations and is usually present post-40 years of age due to sudden changes in the hormones, which can happen. Another main reason which leads to melasma is excess sun exposure. Melasma presents as hyperpigmented areas most often formed within the cheeks, sides of the forehead, and nose areas. They are asymptomatic and are usually cosmetically bothersome. They are harmless, but due to being bothered by some, they may be reduced in appearance with multiple procedures and medications. Medications still have limitations due to their penetration being less than that of while undergoing procedures. Therefore, I advise you to undergo procedures coupled with medications.
1. Glutathione treatments are done in multiple forms. It is available as oral medications may be consumed once daily at night after food and may be continued for at least one year for better results. In addition, Glutathione serums may be applied once daily at night and may continue for months or years together. Glutathione creams and face washes are also available, which may be used similarly. However, Glutathione may cause skin photosensitivity, wherein the skin gets sensitized. As a result, it may cause hyperpigmentation, irritation, or skin redness when exposed to the sun for long durations in the morning. Therefore, in case of consuming or applying Glutathione, it is always advised to use an adequate amount of sunscreen on the face and other exposed body parts to prevent sun damage to the skin. Injections available for your condition are any Glutathione treatments in the form of topical or oral medications that may help increase the skin's brightening effect and brighten the skin by a single or two tones rather than causing a whitening effect. It brightens the body as well as facial skin. However, depending upon the skincare routine and maintenance routines, they may last for up to 5 or 6 years if looked after.
2. Apart from the same, there are also other treatments, including platelet-rich plasma (PRP) with micro-needling. It uses one's own blood and extracts the blood growth factors, which are applied to the micropore. Applying platelet-rich plasma helps stimulate the area to reduce the hyperpigmentation intensity. These are usually done in sessions of at least six every four weeks.
3. Glycolic acids with Kojic acid chemical peels are also available, which are solutions supplied onto the face, left for 5 to 10 minutes, and then washed off. This procedure is also done every two weeks for at least six sessions.
4. Laser techniques, including carbon lasers, erbium blazers, and Q switch lasers, are also available in which the laser beams are directed into the melanin under the skin, which destroys the melanin and regularizes their production, thereby reducing the intensity of hyperpigmentation. This is also done every three weeks for at least six sessions.
All these procedures help with reducing the intensity of hyperpigmentation, which is caused due to melanin. These can be used along with the medications and are done at a dermatologist's clinic. Therefore I would like to advise you to consult a dermatologist in person in order to undergo the treatment.
Thank you.