Melasma & Pigmentation

Melasma is a chronic skin condition causing brown or grayish patches—typically on the cheeks, forehead, nose, and upper lip. It's triggered by hormones (pregnancy, birth control, hormone therapy) combined with sun exposure. More common in women and in patients with medium-to-darker skin tones. It's not dangerous but visually persistent.

No—melasma is managed, not cured. Treatment can dramatically fade and control the pigment, but the underlying tendency remains. Anyone promising to permanently "cure" melasma with one treatment is misleading you. Realistic expectation: significant fading with ongoing maintenance and strict sun protection.

A layered approach: a topical prescription regimen (hydroquinone, tranexamic acid, or alternatives), gentle in-office treatments (specific picosecond laser settings, gentle peels), and absolutely strict sun protection. Aggressive treatments can worsen melasma—we use gentle, consistent approaches.

Melasma is hyperactive pigment cells responding to triggers. Aggressive heat/light treatment is a major trigger—the very thing the pigment cells respond to. We use specific picosecond laser settings tuned to fragment pigment without overheating the skin. The patient's biggest job: sun protection 365 days a year.

Most patients see significant improvement after a series of 2 to 4 in-office sessions, scheduled 4 weeks apart, combined with daily home regimen. Annual follow-up treatments may be needed to maintain results. Stopping sun protection or topicals usually means rapid return of pigment.

Almost always—at least partially—if you stop maintenance. Hormonal events (pregnancy, hormone therapy), sun exposure, even heat exposure can trigger return. Patients with consistent home regimen and strict SPF maintain results longest. Think of melasma like a chronic condition requiring ongoing management.

Mineral (zinc oxide/titanium dioxide) SPF 30 or higher, reapplied every 2 hours when outdoors. Mineral filters reflect both UV and visible light—visible light is a melasma trigger that chemical sunscreens miss. We carry tinted mineral sunscreens that also block visible light effectively.

Melasma laser treatment is $400 per session. A series of 2 to 4 sessions, scheduled 4 weeks apart, is typically recommended for optimal clearance. Topical home regimen is billed separately. We design a complete plan with honest total cost at consultation.

Light peels can be helpful as part of a layered approach—especially the Herbal Green Peel for resistant melasma. Aggressive peels can backfire. We use peels strategically, never as the primary treatment.

Yes—avoid aggressive IPL, ablative lasers, and very deep peels without specific melasma expertise. Heat-generating treatments (RF, intense lasers, even saunas) can flare melasma. We screen treatments for melasma patients and recommend gentler alternatives.

Sun spots are localized pigment deposits from UV damage—they're isolated, well-defined, and respond well to IPL. Melasma is diffuse, often symmetrical, hormonally driven, and responds badly to aggressive IPL. The treatment approach is very different. Misdiagnosing melasma as sun damage is a common reason patients get worse with the wrong treatment.

Book a complimentary skin consultation. We'll examine the pigment pattern, distinguish melasma from sun damage, and design a treatment plan. Call (806) 701-5840 or book online.