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When you see brown patches appearing on your face, you might assume it is sun damage or age spots.

But it may be a more stubborn condition called melasma.

Melasma is easy to identify but difficult to treat with long-term results.

Fortunately, new technologies are finally offering solutions and clear, even skin for those with this persistent issue.


Causes of Melasma

Melasma is a pigmentary condition that affects more than five million Americans, most of them women.

Melasma typically appears as symmetric blotchy hyperpigmented patches on the face, usually the cheeks, bridge of the nose, forehead, chin and upper lip. In some cases, the darkened skin can give the appearance of a mustache or “uni-brow.”

Melasma also appears on other parts of the body prone to sun exposure, such as the neck and forearms.

Many people say their melasma worsens in the summer with increased sun exposure and improves in the winter.

Many women experience melasma during pregnancy or after starting or changing hormonal birth control, linking melasma to hormonal changes.

Types of Melasma

Melasma occurring during pregnancy is called chloasma or "the mask of pregnancy." Increased levels of estrogen, progesterone and melanocyte-stimulating hormone levels during the second and third trimesters of pregnancy may trigger the condition. Postmenopausal women who receive only estrogen are less likely to experience melasma than those who receive progesterone. Dermal melasma is caused by the presence of melanophages, or cells that ingest melanin, throughout the dermis. Epidermal melasma is the presence of excess melanin in the superficial layers of skin. In the fourth type of melasma, excess melanocytes are present in the skin of dark-skinned individuals. ​ Melasma vs. Hyperpigmentation Hyperpigmentation and melasma are two different conditions. Hyperpigmentation can be any darkened skin discoloration. Sun damage, acne scars and age spots can all be categorized as hyperpigmentation. Much like general hyperpigmentation, melasma appears in the form of discoloration on the skin and is exacerbated by exposure to the sun. But while hyperpigmentation can be readily improved with topical treatments, laser treatments and peels, melasma is more deeply rooted. Even when melasma is successfully treated at the surface, underlying causes such as hormones can trigger a recurrence.


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Microdermabrasion uses a rapid stream of particles to exfoliate the surface of the skin. By sweeping away dead skin cells, the treatment creates more even texture and tone. Microdermabrasion also triggers collagen production and new cell growth in the deeper layers of skin. Dark spots near the surface are improved, and new layers come to the surface for healthier-looking skin.

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Topical treatments

Some women experience improvements in their melasma through topical treatment regimens and diligent sun protection. Providers may recommend prescription lightening agents such as hydroquinone, tretinoin, corticosteroids, or azelaic acid or kojic acid to help lighten melasma. Retinols can also help improve the appearance of melasma. PCA SKIN® offers a full line of products that can reduce the appearance of melasma and other discolorations. The Pigment Bar, Pigment Gel and C&E Strength Max work together, day and night, to treat melasma and improve visible signs of aging.

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The MicroLaserPeel precisely ablates, or burns away, the outermost layers of the skin. The scarred and marked top layers of skin peel away to reveal fresh, younger-looking skin beneath. Women who are pregnant or breastfeeding are not good candidates for melasma treatment. Wearing a high-SPF sunscreen is the best way to prevent the worsening of melasma until you are no longer pregnant or breastfeeding. Melasma can be stubborn. It may take a few months of treatment to see improvement, and repeated treatments may be necessary to achieve desired results. After treatment, sun protection is critical to preventing melasma from recurring.

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Halo™ is a hybrid fractional laser that uses both ablative and non-ablative wavelengths to penetrate microscopic areas of the skin. Halo is customizable, targeted and non-invasive. Treatment can be repeated as necessary to maintain or boost your results.

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