Although dozens of products are available over the counter, consult a dermatologist to determine the most effective treatment strategy for you. This may include products that require a prescription. Generally, lotions available with a prescription contain higher percentages of the ingredients helpful in treating melasma, and improvement will be much more dramatic.

When searching for a lotion to treat melasma, make sure it contains the active ingredients proven to be the most effective. Hydroquinone lightens the skin by interfering with melanin production. It is the No. 1 bleaching agent used to treat melasma, most frequently prescribed at a 4 percent strength. Hydroquinone can be used alone, but it is often combined with other agents -- such as acids, retinoids and steroids -- to heal, regenerate, protect and reduce irritation to the skin. A "triple cream" prescription is an effective combination of hydroquinone, retinoids and an anti-inflammatory. Combined with other active ingredients, the hydroquinone penetrates deeper than on its own.

Typically, lotions must be applied once or twice a day for as long as three months for visible results, and require continued use to maintain results. Proper sun protection is essential, too, because sun exposure can reverse the lightening effects. Use products sparingly. A dermatologist should monitor you for irritation and side effects, such as discoloration, with prolonged use.

Darker skin or problem skin may require more aggressive treatment in addition to lightening creams. Microdermabrasion and chemicals peels with salicylic acid and glycolic acid remove skin cells that hold the excess pigment that causes melasma. These therapies remove the damaged layer cells, revealing a fresh and even layer of skin. Intense pulsed light, or IPL, therapy uses high- intensity light pulses of heat to vaporize the darkened area, removing the discoloration without damaging the skin’s surface.