Effective strategies for melasma treatment include prescription topicals and strict sun protection. Combinations of hydroquinone, tretinoin, and steroid cream in varying concentrations and percentages are standard melasma management, resulting in improved absorption and effectiveness. Non-prescription lightening agents, like vitamin A and C,  kojic acid, and niacinamide, show benefits for melasma skin discoloration.

Cyclical use of prescriptions, natural remedies and chemical peels can prevent and maintain results.

Oral tranexamic acid is very effective for melasma. Oral supplementation with licorice extract, beta-carotene, and astaxanthin, and polypodium leucomotos, can reduce damaging effects of the sun and optimize results. Tinted dally sunscreen use for UV, visible and infrared light protection is essential.