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Lightened, Not Cured

Melasma Treatment

Melasma is a patterned brown or grey-brown discoloration, usually across the cheeks, forehead, upper lip or jawline. It is driven by hormones, sun and heat, and it is the most stubborn pigment problem in dermatology. We will say this plainly before you spend anything: melasma cannot be cured. It can be lightened substantially and held there, and that is what a good plan is built around.
BEFORE & AFTERVIEW SERVICES
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Melasma Treatment
Melasma Treatment

What Is Melasma?

Melasma is an overproduction of pigment by cells that have become overactive rather than simply sun-damaged. That distinction matters, because it is why melasma behaves differently from ordinary brown spots. Sun spots sit where the sun put them and respond well to being removed. Melasma sits in skin that will make the pigment again the moment it is provoked. It is far more common in women, and far more common in deeper skin tones, and it is frequently set off by pregnancy or hormonal contraception — which is where the old name, the mask of pregnancy, comes from.
Sun Damage
Pigmented Lesions
Texture & Pores
Acne Scars
Vascular Concerns
Fine Lines & Wrinkles
Skin Laxity
Redness & Rosacea
The Central Business District

Southern Skin and Wellness is located directly in the heart of the New Orleans CBD.

How We

Treat It

Treatment is layered, and the layers are not optional.

  • Photoprotection first. Broad-spectrum mineral sunscreen with iron oxide for visible light, reapplied, plus hats and shade. Without this nothing else holds.
  • A topical regimen selected at consultation to reduce pigment production rather than only to lift what is already there.
  • Laser, used conservatively. When we treat melasma with a laser, we use low-energy, low-density settings across a series rather than a single aggressive pass, and we choose the wavelength for your skin type. The goal is gradual lightening without provoking inflammation.
  • Maintenance. Melasma relapses. Planned maintenance is part of the treatment, not a sign it failed.

Dr. Michael Lindley, MD, performs the laser treatments, assisted by Kathryn, RN.

Why It Comes Back

Four things reliably provoke melasma, and any plan that ignores them fails:

  • Ultraviolet light. Even incidental daily exposure. This is the biggest single factor.
  • Visible light and heat. Melasma is one of the few pigment conditions provoked by heat itself and by visible light, which ordinary sunscreens do not block. Tinted mineral sunscreen matters here in a way it does not for other conditions.
  • Hormones. Pregnancy, hormonal contraception, and hormone therapy.
  • Aggressive treatment. Melasma treated too hard gets worse, not better. Inflammation is a trigger, and heat-based devices used at the settings that work beautifully on sun spots can drive melasma into a rebound that is harder to treat than the original.

That last one is the reason melasma should not be treated the way a brown spot is treated, and the reason we go slowly.

Melasma Treatment

Before & After

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Expect

What To

Expect gradual change over months rather than a dramatic result in a session or two. Most patients see meaningful lightening across a series, with the best results in those who are consistent with sun protection and topicals between treatments.

Expect it to fluctuate. Melasma is typically worse in summer and better in winter, and it will flare with a sunny holiday, a pregnancy, or a change in hormonal contraception. A plan that assumes this is a plan that works.

And expect us to go slower than you may want. Patients often arrive having been treated aggressively somewhere else and having ended up darker. Getting there quickly is not one of the options.

Melasma Treatment

Before You Book

Come to the consultation with your history: when it started, whether it followed a pregnancy or starting contraception, what has been tried before, and whether anything made it worse. Your skin will be imaged so we can see how deep the pigment sits, which changes what is realistic. If your pigment turns out to be sun damage rather than melasma — which happens often — that is better news, and the plan changes accordingly.

Next, read about

Brown spots and sun damage — the pigment melasma is most often confused with. It behaves completely differently and usually clears in one to three treatments.

Laser treatment for skin of color — melasma is far more common in deeper skin tones, and deeper skin needs a more cautious approach to every pigment treatment.

All concerns we treat — the full list, organised by what you notice rather than by what we sell.

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Controlled.

Not Cured.

If a clinic promises to clear your melasma, be careful. What is achievable is substantial, sustained lightening with a regimen you keep up, and honest maintenance after that. We would rather tell you that at the consultation than have you find out after a course of treatment.
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10AM – 6PM
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