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Tackling Melasma

As a mama of two, I’ve always been honest with my PFAMily: I’ve suffered from melasma.

And...I know my PFAMily has too.

According to the Dermal Institute, this skin condition affects more than five million Americans, 90% of them being women.

While it is a stubborn condition that should be treated on an individual basis, I do recommend a trifecta of products, in-office treatments and, of course, preventative steps, for all of my clients.

What is Melasma? 

The American Academy of Dermatology defines melasma as a pigmentary condition that causes gray-brown patches, usually on the cheeks, bridge of the nose, forehead, chin and above the upper lip. Melasma can also appear on other parts of the body that are exposed to the sun, like the forearms and neck.

Melasma does not cause any symptoms that you can feel, but it can change the way your skin looks (and maybe your confidence levels too!).

What Causes Melasma? 

Melasma can be caused by a combination of factors, including: sun exposure, hormones and genetics.

Much like other forms of hyperpigmentation, melasma is exacerbated by exposure to the sun. Ultraviolet (UV) light from the sun stimulates melanocytes (color-producing cells in the skin) to produce too much pigment, resulting in gray-brown patches on the face. Melasma is often worse in the summer, when we spend more time outside in the sun.

In addition to (and sometimes, independent of) sun exposure, hormones seem to trigger melasma. Up to 70% of pregnant women suffer from melasma, and the condition is sometimes referred to as the “mask of pregnancy.” Hormonal contraceptives and other hormone therapies can also instigate melasma. I had a FULL mask of pregnancy with my first baby, Arrow.



Finally, people with darker skin (such as those with Latin/Hispanic, African-American, Asian, Indian or Middle Eastern descent) are more likely to get melasma as they have more active melanocytes than people with lighter skin. People who have a blood relative who had melasma are also more likely to get melasma. Who knew!

How to Treat Melasma

Melasma is difficult to treat (and often depends on severity), but there are ways to tackle this stubborn pigmentary condition.

At-Home Treatments 

It’s important to treat melasma with a tailored medical-grade skincare regimen that combines multiple brightening actives recommended by the National Institutes of Health, like vitamin C, vitamin E, arbutin, kojic acid and glycolic acid, to subdue the overactive pigment cells and eliminate the excess pigment that is already in the skin. Keep in mind, once you start seeing positive progress with your skin, that is not the time to ease up on your lineup. Persistence with these key ingredients is crucial for long-term results and to prevent return of hyperpigmentation.

I recommend a trio of products (used over the course of at least three months) to treat melasma:

Perfect Tone Pads

Perfect Tone Pads contain the most effective botanical skin brightening agents, including kojic acid, arbutin, and bearberry. These pads can be compounded in the office with prescription hydroquinone - the #1 recommended treatment option for melasma.

C Glow

This potent vitamin-rich serum helps lighten the skin and treats uneven pigmentation. C Glow is a high concentration L-ascorbic acid (20%) serum. In addition to it’s ability to increase collagen levels in our skin L-ascorbic acid inhibits an enzyme called tyrosine from converting into melanin (the pigment that darkens the skin). The result is brighter and more evenly toned skin. C Glow also contains vitamin E and ferulic acid which work together with vitamin C to enhance it’s antioxidant potential. I’ve actually written an entire blog post on why it’s vitamin C’s world and we are all just living in it!

Perfect Change Serum 

Perfect Change Serum’s powerful combination of retinol and TCA helps rejuvenate and lighten uneven skin. The serum contains TCA, a chemical peel ingredient that encourages resurfacing of the skin and can help treat melasma. The benefits of retinol are well known and plentiful. Improving uneven pigmentation whether from melasma or sun damage is only one of this ingredient’s well studied effects.


This client of mine had incredible success in treating her stubborn melasma. These photos were taken a few months after use of the aforementioned products ONLY. There were no in-office treatments performed. She has been able to maintain her results one year later with her PFAM lineup and vigilant SPF protection.

In-Office Treatments 

If at-home skincare treatments don’t get rid of your melasma, an in-office service may succeed. New procedures for melasma from our melasma treatment collection include:

  • Cosmelan MD Depigmentation Peel:This three-month light peeling treatment eliminates melanin patches on the face resulting from melasma. It’s incredibly effective on ethnic skin, too, which is rare among the majority of lightening skin treatments!
  • Melanostop Depigmentation System: This minimally invasive add-on to microneedling attacks pigment from multiple pathways through the use of tranexamic acid. For the full results, at least three treatments are recommended! 
Treatments may need to repeated to maintain optimal long-term results and maximum effect.


Platelet-Rich Plasma Treatments & Melasma

New research published in the Annals of Dermatology has also demonstrated the effectiveness of platelet-rich plasma (PRP) treatments in the reduction of melasma. PRP treatments utilize your blood’s platelets, which are loaded with growth factors that initiate the healing process in the body. One of the growth factors released from platelets has been shown to have a dose dependent effect on inhibiting the enzyme that creates melanin, therefore decreasing melasma. PRP treatments can also increase skin volume and tone, resulting in more ‘glowing skin,’ countering the effects of melasma. 



Prevention is the Best Medicine

According to the American Academy of Dermatology, one of the most common and most effective treatments for melasma is sun protection. This means wearing sunscreen daily and reapplying every two hours (even if you’re just sitting by a window or the day is cloudy), as well as wearing a wide-brimmed hat and avoiding being in direct sunlight at its strongest points in the day. Just a small amount of sun exposure can make melasma return after it has faded! Imagine spending a year of your time, money and dedication on your melasma battle, only to have it completely ruined after one careless day in the sun. Don’t let this happen to you!

Acclaimed Director of Pigmentary Disorder and Multi-Ethnic Skin Clinic at Mass General Hospital, Dr. Arianne Kouroush has noted that melasma can be worsened by not only the sun’s rays, but also heat and visible light. This means that sunscreens that protect against skin cancer aren’t always enough to ward off melasma. So, even if you’re face is slathered in sunscreen and covered by a hat, but your legs are still hot in the sunlight, you may be at risk for triggering melasma.This principle also applies for hot yoga, steam rooms and even cooking. (Mind blown, right?!)

While it may seem impossibly tricky and incredibly stubborn, there is hope to treat this condition. Between brightening ingredients, skincare services and vigilant sun prevention, you can take on your melasma!

Dr. Zoe

Shop for Perfect Tone Pads,C Glow and Perfect Change Serum - or book your service today. 

Perfect Face Aesthetic Medicine

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