For the melasma, treatment options include treatment with vitamin C
and hydrocortisone, peel with carbon dioxide snow
and alexandrite
and ND-Yag Q-Switched laser treatment preceded by a hydroquinone-based application. But get it done after the course of Accutane. Please discuss these options with your dermatologist.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided.