Why melasma needs a combined plan
Melasma is a long-term pigment condition, not a single spot to erase. Sun, heat and hormones, such as pregnancy or birth control, drive it, and it often comes back. Daily broad-spectrum SPF 30 or higher and the right topical skincare come first; laser sessions are an add-on that can help pigment fade faster.
That’s why melasma plans here pair in-office treatment with medical-grade skincare at home. Our melasma before-and-after photos show patients after four weeks on a personalized skincare regimen. Individual results vary.
Melasma vs sun spots and other dark spots
Not all dark spots are the same, and the difference changes the plan.
Melasma
Symmetrical brown or gray-brown patches, usually on the cheeks, forehead, upper lip or chin. Hormones and heat play a role, so it responds more slowly and can rebound.
Sun spots, age spots and freckles
Flat, well-defined spots caused by UV exposure. They usually respond more predictably to laser and IPL.
Post-inflammatory hyperpigmentation
Dark marks left after acne, a rash or a skin injury. They often fade with time, skincare and sun protection, and laser can help in selected cases.
How the Q-switched laser works
The laser delivers very short, high-intensity pulses of light that break up clusters of pigment in the skin. Your body then clears the fragments over the following weeks, and tone looks more even as the skin renews. It treats the face, neck, chest and hands.
We use a dual-wavelength Q-switched laser (1064/532 nm), a long-established laser for pigment. The 532 nm wavelength reaches pigment near the surface and 1064 nm reaches deeper, while the healthy skin around it is preserved. It’s the same system we use for laser tattoo removal.
Rebound risk, and how your plan lowers it
Lasers can backfire on melasma. Settings that are too aggressive can trigger rebound darkening, and repeated strong treatments can leave mottled light patches. Heat-based options such as IPL and ablative resurfacing can also make melasma worse. Your plan is built to lower that risk:
- Gentle, skin-type-matched laser settings rather than aggressive ones
- Topical skincare before and between sessions
- Sessions spaced so the skin can settle
- Strict daily SPF 30 or higher, and no tanning beds
- Managing triggers like heat and sun, with maintenance over time
Darker skin tones, and why a physician
Our Q-switched laser is calibrated for Fitzpatrick skin types I–VI. For deeper skin tones, the 1064 nm wavelength is typically used at gentle settings, because deeper skin is more prone to pigment changes after any laser. Dr. Pabona reviews your skin type and history before choosing settings.
Not every dark spot is cosmetic. A spot that is new, changing, irregular or bleeding should be medically evaluated before any laser treatment. Dr. Pabona, a board-certified internist, looks at your skin, history and triggers first, then builds the plan at a skin consultation.
What to expect, sessions and results
During treatment
Most people describe a light, warm snapping sensation. Discomfort is minimal, and most clients tolerate treatment well without numbing.
Afterward
Mild redness or flaking for a few days is common, with no significant downtime, so most clients return to daily activities right away. Treated sun spots can look darker before they fade. Avoid direct sun, tanning beds and harsh exfoliants, and use SPF 30 or higher every day.
How many sessions
A series of 2 to 4 sessions is common for melasma, and results build progressively. The number depends on your skin type, how deep the pigment sits and your sun exposure history. For widespread sun damage without melasma, an IPL photofacial may also fit.
Melasma treatment pricing
Choose a single session or a two-session series. Your skin consultation is complimentary with the purchase of a treatment or skincare product, and CareCredit financing is accepted.
Single session: $399
For mild to moderate melasma or isolated dark spots that need one corrective treatment.
Two sessions: $699
For progressive melasma fading and clearer skin over a short series.
Epidermis
- Epidermis
- Dermis
- Deep dermis
- Fat pads
- Muscle
Questions
Common questions about melasma treatment
What is the most effective treatment for melasma?
For most people, the foundation is daily broad-spectrum sunscreen plus topical skincare that slows pigment production. Laser treatment is an add-on that can speed fading when topicals alone aren’t enough. Because melasma is driven by sun, heat and hormones, the most successful plans combine all three approaches and continue with maintenance rather than relying on a single treatment.
Which laser is best for melasma?
No laser cures melasma, but a Q-switched 1064 nm Nd:YAG used at low, gentle settings, sometimes called laser toning, is among the most studied options and is widely used in Korea and across Asia. Aggressive settings, IPL and ablative lasers can worsen melasma. Our dual-wavelength Q-switched laser lets Dr. Pabona match the wavelength and settings to your skin type.
How many laser melasma treatments will I need?
A series of 2 to 4 sessions is common for melasma. The exact number depends on your skin type, how deep the pigment sits and your history of sun exposure. Isolated sun spots often need fewer. Because melasma can return, Dr. Pabona may also suggest maintenance sessions and a skincare routine to protect your results over the long term.
Does laser melasma treatment hurt?
Discomfort is minimal. Most people describe a light snapping or warming sensation with each pulse, and treatment moves quickly. Most clients tolerate it well without numbing cream. If an area feels more sensitive, let us know during the session. Afterward, the skin may feel warm or look slightly pink for a short time, similar to a mild sunburn.
Can melasma come back after treatment?
Yes, it can. Melasma is a chronic condition linked to sun, heat and hormones, so even after it fades, those triggers can bring it back. Daily sunscreen, limiting heat exposure and a consistent skincare routine help keep it under control. Many people plan occasional maintenance treatments, and Dr. Pabona can adjust your plan if pigment starts to return.
What should I avoid after laser pigment treatment?
Avoid direct sun, tanning beds and harsh exfoliants such as scrubs or strong acids while your skin recovers. Use a broad-spectrum SPF 30 or higher every day, even when it’s cloudy, and reapply when you’re outdoors. Sun exposure is the biggest trigger for pigment returning, so protection is what keeps your results. Follow your post-treatment care instructions for the rest.
Should I avoid saunas and hot baths if I have melasma?
Heat is a known melasma trigger, so it’s worth limiting. Skip saunas, steam rooms, hot tubs and long bathhouse soaks for several days after a laser session, and keep them short and occasional in general. Heat can stimulate pigment cells even without sun exposure. If you love the Hot Springs baths, shorter, cooler soaks and consistent skincare help.
