The real reason melasma returns after laser — and what the complete management protocol looks like.
Most patients with melasma have had laser treatment that worked initially — then watched their pigmentation return within weeks. This leads to the belief that 'laser doesn't work for melasma.' The laser worked. The mistake was using it alone.
Melasma is a chronic condition driven by hyperactivated melanocytes — cells that are continually stimulated by UV, hormonal signals, and inflammatory triggers. Laser removes existing melanin deposits but does nothing to reduce the ongoing stimulation driving new pigment production.
Dr. Lee's approach to melasma management combines: (1) in-clinic pico-laser to remove existing deposits; (2) prescription topical brightening therapy to suppress melanocyte activity between sessions; and (3) strict SPF50+ daily sun protection to block the primary UV stimulus.
Melasma can be very well controlled — 70–80% sustained improvement is achievable with consistent three-pillar management. Complete permanent cure is rare, but most patients reach a point where melasma is no longer visibly affecting their confidence.
6–12 for meaningful melasma improvement. Maintenance sessions every 1–3 months thereafter.
Yes — if the wrong laser setting is used, or if treatment is done without adequate sun protection post-session, post-inflammatory hyperpigmentation can worsen the appearance. Dr. Lee's conservative initial settings minimise this risk.
Hydroquinone (where available), tranexamic acid, niacinamide, azelaic acid, and retinoids — formulated for your skin tolerance level at consultation.
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