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Most of the creams on the market target the symptoms of melasma the pigment in the skin by increasing cell turnover, but not the primary cause of the condition, which are the skin cells that produce the pigment, says Ariel Ostad, MD, a board-certified dermatologist in New York City

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For the long-acting injectables, because they are administered subcutaneously (under the skin) rather than orally, they bypass the gastrointestinal absorption process that can be influenced by stomach contents

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