Melasma is a skin condition that causes gray or brown spots of discoloration on your skin. It can happen to anyone, and is not dangerous to your health, but it can be an annoying cosmetic issue. Melasma most commonly involves sun-exposed areas of your skin including:

  • cheeks
  • upper lip
  • chin
  • forehead
  • other sun-exposed skin (occasionally)

It is caused by melanocytes in skin creating extra pigmentation, and melasma often affects women with darker complexions because they have more melanocytes. The most important factor in development of melasma is sun exposure.

Melasma is also associated with female hormones, and it is more common in people who are pregnant or taking hormonal birth control. Melasma can also be caused by genetics and certain medications.

Melasma is more common in women than men. People with light brown skin from regions of the world with intense sun exposure experience it.

In the United States, it is estimated to range from 8.8% among people of Latino descent, to 13.4% to 15.5% in Arab-Americans living in Michigan, to 40% of females of southeast Asian populations. It’s important to note that the stress of enduring racism, discrimination, and racist systems may play a part in developing the condition beyond genetics. The condition is not associated with skin cancer or does not carry a risk of developing melanoma.

There are certain home remedies for melasma like:

  • applying aloe vera to your skin
  • ingesting glutathione
  • using high SPF sunscreen

There are also over-the-counter (OTC) lightening creams available, most of which contain the skin-lightening agent, hydroquinone. Chemical peels are another treatment option.

There is no consensus even among dermatologists that laser treatment is a good option. It can be considered if the condition does not respond to topical treatments as a first line of treatment, and chemical peels as a second line of treatment. The risk of inflammation and hyperpigmentation is high. The trials involving laser treatments are limited by small sample sizes.

A 2012 research review showed that there are several types of lasers that may be used to treat melasma.

PicoSure

PicoSure is a laser that turns energy into pressure as opposed to heat. It works quickly to treat melasma below your skin at its source. The procedure itself is quick and only slightly uncomfortable. You may experience a stinging sensation similar to a rubber band snapping on skin. One study found that PicoSure reduces melasma without other reported side effects like hyperpigmentation.

Fractional

Fractional laser resurfacing, sometimes known by the brand name, Fraxel, makes microscopic holes in your skin that stimulate the growth of new and healthy skin cells. There is a prickling sensation involved and usually topical anesthetic is applied before the procedure.

Your skin looks red or discolored, and raw immediately after. But after 3 to 5 days of recovery, your skin will look brighter and more even.

IPL

An Intense Pulsed Light laser (IPL) uses multispectrum lights in different wavelengths to target certain colors in your skin. This treatment may actually make melasma worse in certain skin tones, so it’s important to consult a dermatologist before treatment.

Q-Switch

The Q-Switch laser, sometimes called The Spectra®, delivers energy into your skin that breaks melanin into smaller pieces, which are then are removed by your body. Q-Switch may also bleach your hair, and the process can cause a stinging sensation.

Lasers are generally considered for people seeking long-term and quick results when other options, like lightening creams, have not been effective.

Laser treatments can be an effective treatment for melasma with one 2017 research review showing that the Q-Switch laser is the most effective, especially in people with darker skin tones.

Another 2017 research review showed that people who experience melasma during pregnancy, and do not plan to become pregnant again are good candidates for laser treatment. People whose melasma is resistant to other treatments and people looking for quicker results are also good candidates for laser treatment.

You should see some improvement after the first session, but three to four sessions spaced about 30 days apart will yield the greatest results. You should see full results in 3 to 6 months. You may need follow-up treatments because sometimes melasma clears days after laser therapy, but returns in about 3 months.

As with many cosmetic procedures, that are potential side effects from laser therapy for melasma. These side effects include:

  • redness or discoloration
  • burning
  • stinging
  • potential for infection
  • allergies to topical anesthesia

Some lasers, including vascular lasers, do not appear to treat melasma. Others have the potential to make melasma worse by causing hyperpigmentation, particularly on Black and brown skin, so consult a professional before deciding which laser is right for you.

After laser procedures, you may feel the following sensations in the area for several days:

  • itching
  • burning
  • stinging

Your skin may also be:

  • red or discolored
  • slightly swollen
  • blistered (in some cases)

Protect your skin from the sun in the recovery process. It’s very important that you avoid sun exposure. Otherwise, any treatment will be unsuccessful.

A health professional should go over all aftercare procedures and advise on the best products to use post-treatment.

To prevent melasma from worsening or returning post-treatment, always wear high SPF sunscreens, even on cloudy days. Your doctor may also recommend that you continue to use a skin-lightening treatment post-laser.

In addition to lasers, other treatment options are available for melasma. These include:

Skin-lightening agents

Skin-lightening agents usually include an OTC moisturizer or lotion. The active ingredient is typically hydroquinone, which bleaches your skin by reducing the amount of melanocytes present.

Chemical peels

A 2012 research review showed that chemical peels come in varying strengths, and they use acids and other ingredients like tretinoin to gently remove your outer layer of skin. Side effects look and feel similar to a sunburn, but once your skin recovers, melasma may be less prominent.

Microdermabrasion

Microdermabrasion is a minimally invasive procedure performed by a licensed esthetician, who uses a tool with an abrasive tip or vacuum suction to slough off your outer layer of skin.

Talk with a medical professional about melasma if it’s still present several months after pregnancy or hormonal changes, or if you experience any pain or itching. If your skin does not heal from a laser within a week, speak with a health professional. It’s also important to get advice on how long to apply skin-lightening agents, and how long to take a break from these agents, to prevent hyperpigmentation.

Laser treatments can be a good option for treating melasma that’s resistant to other treatment options, like skin-lightening agents or chemical peels. Lasers permeate your outer layer of skin, resulting in cell renewal for brighter, more even skin.

In some cases, laser treatments for melasma can actually cause hyperpigmentation, worsening the condition, so always check in with a dermatologist about what’s right for you.