Melasma & Freckles Treatment

What it is

Melasma appears as brown or grey-brown patches, usually on the cheeks, forehead and upper lip, and is linked to sun exposure, hormonal changes and genetic tendency. Freckles are small light-brown spots that become more visible with sun exposure. Treatment starts by identifying the type and depth of the pigmentation, because melasma and freckles need different approaches; the plan may include sun protection, topical treatments and in-clinic procedures, set by the doctor after an assessment.

Who may benefit, and why people ask about it

• Melasma patches on the face, including those that appeared during pregnancy or with hormonal medicines.
• Freckles that become more visible with sun exposure.
• Spots linked to repeated sun exposure.
• Uneven skin tone on the face.
• Wanting to understand the cause of the spots and the options for managing them before making any decision.

Treatment can help some people lighten the appearance of the spots, and the response varies with the type and depth of pigmentation and the skin type.

What the consultation covers

• Questions about when the spots started, any change in them, sun exposure, hormonal factors such as pregnancy or hormonal medicines, and family history.
• A review of the medicines and skincare products you use, and any previous treatments and how your skin reacted.
• An examination of the skin; the doctor may use a magnifier or a special light to help identify the type and depth of pigmentation.
• A check of any spot that has changed in size, shape or colour, as it may need medical evaluation before any cosmetic treatment.
• An assessment of your skin type and how likely it is to darken after some procedures.
• Setting the plan, and discussing expectations and the importance of ongoing sun protection.

Questions you may want to ask the doctor:

• Are my spots melasma, freckles, or another type of pigmentation?
• What is a realistic improvement in my case?
• Could the treatment make the pigmentation worse?
• How do I keep the improvement, and what sun protection do I need every day?

What a visit looks like

1. Registration, and review of the health-history and consent forms.
2. The examination; clinical photos may be taken with your consent under consistent lighting to track change, kept in your medical file only and never published.
3. A discussion of the plan, which may include, depending on the case: topical treatments, a light chemical peel, or laser or light treatments in selected cases.
4. If an in-clinic procedure is done: the skin is cleaned, the procedure is carried out, then the skin is soothed and sunscreen is applied.
5. Written instructions, and follow-up appointments to review the response and adjust the plan.

The number of visits or sessions, their length and the interval between them vary from person to person and are set by the doctor based on the assessment.

Preparation

• Please avoid the sun and use sunscreen every day before, during and after treatment.
• Please tell the doctor about all medicines, including those that make the skin more sensitive to light and hormonal medicines, and about the skincare products you use.
• Please tell the doctor if you are pregnant, breastfeeding or planning a pregnancy; some topical ingredients and procedures are avoided or postponed in these situations as a precaution.
• Before in-clinic procedures: you may be asked to stop some products, such as topical vitamin A derivatives and exfoliants, for a period the doctor specifies.
• Please avoid tanning, and waxing or threading in the treatment area, for a period before procedures that the doctor specifies.
• Please tell the doctor about any history of cold sores or raised scars (keloids).

After the session and possible side effects

Common effects, usually temporary:

• Redness, dryness, peeling or mild stinging with topical treatments or peels.
• Temporary darkening of treated spots after some procedures.

Less common effects:

• Increased pigmentation, or spots lighter than the surrounding skin, especially in darker skin or with sun exposure.
• Melasma returning or worsening after some procedures, especially with heat or sun.
• Blisters, crusting, infection or scarring after some procedures.

Aftercare instructions may include strict sun protection, not picking crusts or scratching the skin, using gentle skincare products the doctor specifies, and avoiding intense heat. Contact the clinic if you notice blisters, increasing pain or signs of infection.

The doctor explains the full list of risks during the consultation.

Limitations

• Results vary from person to person and cannot be predicted precisely in advance.
• Melasma is a long-term condition that tends to recur, especially with sun, heat or hormonal changes, so it often needs a follow-up plan.
• Improvement takes time, keeping it requires ongoing sun protection, and freckles may reappear with sun exposure.
• Pigmentation in the deeper layers of the skin may respond less to treatment.
• The doctor may advise against some treatments or postpone them in situations including: pregnancy or breastfeeding, a recent tan, an active skin infection, a tendency to keloids, a high likelihood of the skin darkening, or expectations the treatment cannot meet.
• Any dark spot that is changing needs medical evaluation first, and no cosmetic treatment starts before it has been diagnosed.