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Hello, In Ayurveda, melasma = vyanga, mainly due to pitta imbalance + stress + heat + toxins (ama) Chronic cases like yours usually need internal + external + lifestyle correction together, not just creams Your case very important -severe + long duration-> deep pigmentation -stress trigger-> major root cause -oily/acne skin-> pitta + kapha imbalance -laser failure-> skin barrier likely irritated So treatment must focus on -pitta cooling most important -liver detox -stress control -gentle skin repair (Not aggressive) Internal medication Take for 3-4 months minimum 1) Mahamanjisthadi kashaya= 15ml + warm water twice daily before meals =best for pigmentation + blood purification 2) Khadirarishtam= 15ml after meals with warm water =helps acne + oily skin + detox 3) Gandhak rasayana= 1 tab twice daily after meals =for skin glow + acne + inflammation 4) Avipattikar churna= 1 tsp with warm water at bedtime =controls pitta + acidity very important in melasma These medicines are commonly used in Ayurveda to reduce pigmentation and balance doshas External applications 1) Kumkumadi taila= 3-4 drops gentle massage at night =improves pigmentation gradually 2) Nalpamradi taila= morning before bath or light leave on =brightenig+ cooling Avoid over layering both-> your current full regimen is likely worsening it Weekly detox (very important) Once weekly= face lepa (simple) -Multani mitti + turmeric + rose water =helps oil + pigmentation If possible (best result) -panchakarma like virechana =chronic melasma often needs detox Diet (this will decide your result so very important to follow) -take amla juice daily -coconut water -ghee -leafy vegetables Avoid -spicy, fried, junk , bakery -tea,coffee excess -late nights -heat producing foods Because melasma is strongly linked to internal heat (pitta) Stress control (most critical in your case) You already identified trigger=stress Do daily -10 min Anulom vilom -10 min walking/sunlight (morning only) Even studies show lifestyle and stress reduction improves melasma outcomes What you must STOP -frequent lasers/peels (already failed) -too many skincare products -steroid creams if using Expected results -4-6 weeks-> mild lightening -3 months-> visible improvement -6 months-> significant control But relapse can happen if stress returns Your case is not a simple cosmetic issue anymore It’s a systemic imbalance (pitta + stress + liver) Ayurveda can help you control and reduce But only if you follow diet + stress + medicines together Do follow Hope this might be helpful Thank you
