Melasma is patchy brown or gray-brown discoloration, usually on the cheeks, forehead, upper lip and chin. It’s a type of hyperpigmentation, which is the umbrella term for any skin that’s darker than the skin around it.
Melasma vs other hyperpigmentation
- Melasma: larger, symmetrical patches, often on both cheeks. Sun, heat and hormones (pregnancy, birth control or hormone therapy) are common triggers.
- Sun spots (age spots): smaller, defined spots on sun-exposed areas such as the face, hands and chest.
- Post-inflammatory hyperpigmentation (PIH): dark marks left after a blemish, rash or irritation.
Are dark spots permanent?
Usually not, but they’re stubborn. Discoloration fades gradually with consistent treatment, and it comes back quickly without sun protection. That’s why daily sunscreen is essential, both during treatment and after.
What fades melasma and dark spots?
Prescription-strength ingredients work faster and more reliably than over-the-counter brighteners.
Dark Spot Corrector Duo (Route66 + 21AA) is our structured plan for melasma, dark spots and stubborn hyperpigmentation. It rotates two formulas in a hypoallergenic, paraben-free pharmacy base:
- Route66: 6% hydroquinone plus 6% kojic acid.
- 21AA: 21% azelaic acid.
Alternating actives targets discoloration from more than one angle, with once-daily use.
21AA 21% Azelaic Acid Cream works on its own for stubborn dark spots, discoloration, redness, post-blemish marks and uneven tone.
Renew & Even Duo pairs Tretinoin Collagen Constructor (for fine lines, texture and firmness) with 21AA (for dark spots, redness and uneven tone). It’s a good fit if you want to treat aging and discoloration together. It’s not for use during pregnancy or breastfeeding, because it contains tretinoin.
How to get the best results
- Wear sunscreen every day, even indoors near windows.
- Keep the rest of your routine gentle: cleanser and moisturizer.
- Be consistent. Discoloration improves gradually.
How to get your prescription
After checkout, you answer a short questionnaire. A licensed medical provider reviews it, typically within 1–3 business days. The prescription is included, with no office visit and no separate doctor fee.
Frequently asked questions
What causes melasma?
Sun and heat exposure, and hormonal changes such as pregnancy, birth control or hormone therapy.
Is hydroquinone safe?
See our full guide: Is hydroquinone safe long-term?
Can I treat melasma while pregnant?
Talk to your provider. Tretinoin is not for use during pregnancy or breastfeeding.
Dark Spot Corrector Duo · 21AA Azelaic Acid Cream · Renew & Even Duo