Melasma is a common form of skin hyperpigmentation that can be very stubborn to treat. With the right combination of treatments — and the right expectations — most of our patients see dramatic fading and learn to keep it that way.
Is your face riddled with brown or gray patches now that you've had children? Melasma is a common type of hyperpigmentation for women to experience during pregnancy — but it doesn't always start there. It can show up with birth control, hormone therapy, a single summer of sun, or sometimes nothing at all.
You've probably already tried bleaching creams that didn't work. Maybe one IPL session that made it worse. You've covered it with foundation for months, wondering if you'll ever just look like yourself again.
Here's the honest truth: melasma can be dramatically faded — but it has to be managed carefully, by someone who actually knows how. That's where we come in.
Get a Real Plan →It's usually a combination — but understanding your triggers is the first step to keeping new patches from forming.
Pregnancy ("the mask of pregnancy"), birth control, hormone therapy, menopause. The most common driver — and the hardest to remove.
Sun makes existing melasma darker — and triggers new patches. Even visible light through windows or from screens can flare it.
Family history matters. Certain skin tones (Fitzpatrick III-V) are more prone. If your mother or sisters have it, your risk is much higher.
Anyone promising you "permanent removal" of melasma is either inexperienced or being dishonest. Melasma is a chronic condition driven by hormones, sun, and genetics — and those don't disappear.
What we can do — and do exceptionally well — is dramatically fade the existing patches, then teach you exactly how to keep them from coming back. With the right plan, our patients live with skin that looks essentially clear for years at a time. That's what success looks like with melasma. Not a one-and-done procedure.
Most patients need 2–3 of these layered together — plus rigorous sun protection. Dr. B builds the plan based on your skin type and severity.
Realistic plan, realistic expectations, real long-term results.
30 min skin assessment
Hormones · sun · genetics
Topicals + in-clinic + SPF
Visible improvement & long-term plan
Cost depends on the combination of treatments and topicals your skin needs. Dr. B builds the plan first and gives you the exact quote at your consultation — no surprises.
"I'd had melasma for 8 years post-pregnancy and tried three different clinics. One actually made it worse with an aggressive laser. Dr. B started me on a careful regimen — peels, prescription topical, BBL at low settings. Six months in, my melasma is 85% faded. I haven't worn full foundation in months. Wish I'd come here first."
"Dr. B was the first provider who told me melasma couldn't be 'cured' — and somehow that honesty made me trust her completely. She built me a real long-term plan and gave me actual product recommendations. My patches are softer than they've been in a decade, and I finally know how to keep new ones from showing up."
The honest answers Dr. B would give you in the room.
Honestly, no — melasma is a chronic condition driven by hormones, sun, and genetics. But it can be dramatically managed. With the right combination of in-clinic treatments and daily home care, most of our patients live with skin that looks essentially clear for years at a time. Anyone promising a "permanent cure" isn't being straight with you.
Appearing typically on the face, melasma consists of brown spots of skin pigmentation most likely to be found in individuals who have gone through hormonal changes. Melasma can also appear on the forearms and neck and is often called "the mask of pregnancy" because it frequently appears during pregnancy. The patches tend to be symmetrical (both cheeks, both sides of the forehead) and have soft, undefined borders.
Three reasons: (1) the pigment goes deeper into the skin than typical sun spots, (2) the underlying triggers — hormones and UV — don't disappear, and (3) melasma can be paradoxically worsened by aggressive treatment. Heat from intense lasers can stimulate more pigment production. That's why experienced providers use the gentlest effective approach first and build up only if needed.
Prescription topicals: subtle fading at 4-6 weeks, more obvious at 12 weeks. Chemical peels: visible improvement after 2-3 sessions (over 6-8 weeks). BBL: pigment darkens for 5-7 days post-treatment, then sheds — true fading visible 3-4 weeks later. Most patients see meaningful overall improvement at the 3-month mark when treatments are layered properly.
If you don't protect against the triggers — yes, almost certainly. Hormone shifts (new birth control, pregnancy, perimenopause) can trigger flares. Sun exposure without strict SPF will bring it back. With consistent daily mineral SPF 50+ (ideally with iron oxide for visible-light protection), home care, and maintenance treatments every 6-12 months, most patients hold their results long-term.
Sun is melasma's biggest fuel. Even brief exposure — driving with the visor up, walking the dog, sitting near a window — can darken existing patches and trigger new ones. We recommend mineral SPF 50+ with iron oxide every morning, reapplied every 2 hours when outside, plus a wide-brim hat in summer. Without rigorous sun protection, every other treatment falls short.
It depends on your specific skin tone and the type of melasma you have. BBL is generally safer for lighter skin tones (Fitzpatrick I-III). Darker skin tones (IV-VI) often respond better to peels and prescription topicals first, with very conservative laser use only if needed. Dr. B will assess your specific skin and tell you straight which approach is safest — and what to avoid.
We hold off on most active melasma treatments during pregnancy and breastfeeding — including prescription topicals, peels, and lasers. Many patients see melasma fade naturally after delivery once hormone levels normalize. We can start an active treatment plan once you're done breastfeeding, and we'll set you up with safe daily SPF in the meantime.
That's a decision between you and your OB/GYN — not us. We can tell you that hormonal birth control is a known melasma trigger, and some patients find that switching off (with their doctor's guidance) significantly improves their condition. We treat what we can with the hormonal situation you choose to maintain.
30 minutes with Dr. B. We'll look at your specific patches, identify your triggers, and build a plan that actually works — with realistic expectations and an exact quote.
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