Why melasma needs a different approach
Melasma is one of the most misunderstood pigmentation conditions — and one of the most mistreated. Unlike a sun spot or a post-acne dark mark, melasma is a chronic, hormonally-driven condition that responds unpredictably to aggressive treatment. Push too hard, and the inflammation from the treatment itself can trigger the pigment to return darker than it started. This is called rebound hyperpigmentation, and it's the reason so many patients say laser treatment "made their melasma worse."
At Plump Medical Spa, melasma is treated as its own category — not as a smaller version of sun spot removal. Dr. Mortazavi uses PicoLazer's dual wavelength (1064nm and 532nm) at conservative, carefully staged settings specifically calibrated for melasma, building improvement gradually across a series of sessions rather than attempting to clear it in one aggressive pass.
What melasma actually is
Appearance
Symmetric brown or gray-brown patches, most often across the cheeks, forehead, upper lip, and chin.
Triggers
Hormonal changes — pregnancy, birth control, hormone therapy — combined with sun exposure. Often called the "mask of pregnancy" for this reason.
Depth
Can sit in the superficial epidermis, deeper in the dermis, or both — deeper melasma is more stubborn and more prone to recurrence.
Behavior
Chronic and recurrence-prone. Unlike a sun spot, melasma rarely disappears permanently after one round of treatment — it needs an ongoing management plan.
Dr. Mortazavi's clinical note
If a provider promises to clear your melasma in one aggressive session, that's a red flag, not a selling point. The physicians who get the best long-term melasma results are the ones willing to go slower. A staged approach takes longer to show results, but it's dramatically less likely to leave you worse off than when you started.
Aggressive treatment vs. the conservative approach
Higher Risk
Aggressive, Single-Pass Treatment
High-energy settings intended to clear pigment quickly
Significant risk of triggering rebound hyperpigmentation
Common cause of "my melasma got worse after laser"
Especially risky on medium-to-deep skin tones
Plump's Approach
Staged, Conservative Protocol
Lower, gentler PicoLazer settings appropriate for melasma specifically
Gradual improvement across multiple sessions minimizes flare risk
Dual wavelength allows fine control matched to your skin tone
Built around long-term maintenance, not a one-time fix
What to expect
01
Assessment
Dr. Mortazavi confirms melasma (rather than another pigment type), assesses depth and triggers, and sets realistic expectations.
02
Conservative Treatment
Gentle PicoLazer settings are applied across the affected area. Most sessions take 20–30 minutes.
03
Monitor & Adjust
Response is assessed before each subsequent session, and settings are adjusted — never automatically escalated.
04
Maintain
Daily SPF and periodic maintenance sessions protect results, since melasma is recurrence-prone by nature.
Who benefits most
Strong candidates
Melasma that has plateaued and is no longer actively changing
Patients frustrated by topical treatments alone with limited results
Any Fitzpatrick skin type — including deeper skin tones
Patients ready to commit to sun protection and a multi-session plan
Worth discussing at consultation
Active pregnancy — melasma often fades postpartum; timing matters
Recent hormonal changes still in flux (new birth control, etc.)
History of rebound darkening from prior aggressive treatment elsewhere
Unwillingness to commit to daily SPF — sun protection is non-negotiable for lasting results
Melasma vs. sun spots vs. post-acne marks aren't the same condition. If you're not sure which one you have, our pigmentation identification guide walks through how to tell them apart before you book.
Pricing
Treatment pricing
PicoLazer melasma protocol — full-face session series
Most patients need 4–8 sessions. Individual session pricing available. By appointment only.
View Pricing & Book →
Frequently asked questions
What is melasma and what causes it?
Melasma is a chronic pigmentation condition that causes symmetric brown or gray-brown patches, most commonly on the cheeks, forehead, upper lip, and chin. It is triggered by hormonal changes — pregnancy, birth control, hormone therapy — and significantly worsened by sun exposure. Unlike sun spots, melasma tends to be deeper, more diffuse, and more prone to recurrence.
Can lasers make melasma worse?
Yes, if treated too aggressively. Melasma is uniquely prone to rebound hyperpigmentation, where overly intense laser settings trigger inflammation that causes the pigment to return darker than before. This is why melasma requires a more conservative, staged approach than sun spots or post-acne marks, performed by a physician experienced specifically with melasma.
Is PicoLazer safe for melasma?
Yes, when performed with an appropriately conservative protocol. PicoLazer's dual wavelength allows Dr. Mortazavi to select lower, gentler energy settings appropriate for melasma, rather than the more aggressive settings used for sun spots or tattoo ink. Treatment is staged gradually across multiple sessions to minimize the risk of rebound darkening.
How many sessions does melasma treatment take?
Melasma typically requires more sessions than other forms of pigmentation, often 4 to 8, spaced 3 to 4 weeks apart, using conservative settings. Melasma is a chronic, recurrence-prone condition rather than a one-time fix — maintenance sessions and consistent sun protection are usually necessary to sustain results long-term.
Will melasma come back after treatment?
Melasma has a high recurrence rate, particularly with sun exposure or hormonal changes such as pregnancy. Daily broad-spectrum SPF is essential to maintaining results. Many patients benefit from periodic maintenance sessions rather than expecting a single round of treatment to be permanent.
How much does melasma treatment cost at Plump Medical Spa?
Melasma treatment with PicoLazer is priced by treatment area, with most patients requiring a full-face protocol across a series of sessions. Current pricing is available on the Plump Medical Spa treatment menu.
Ready to address your melasma, safely?
Consultations Tuesday through Saturday. Every session performed personally by Dr. Mortazavi.