Melasma
Patches that sit deeper than a freckle and answer to light, heat and hormones at once. Melasma is managed rather than cured — which makes the order of treatment matter more than the machine.
Both
Sun and hormones drive it
3–6 mo
A realistic first plan
2–3
Treatments layered
SPF 50
Daily, non-negotiable
Self-check
Is it actually melasma?
Tick what sounds like you. Nothing is stored, and it is not a diagnosis — it just makes the consult faster.
Often mistaken for
Age spots
Single spots with crisp edges, usually where the sun hit hardest — and far easier to clear.
Post-inflammatory marks
Left behind by a spot or a scratch. They fade on their own within months; melasma does not.
Freckles
Small, scattered, present since childhood and genuinely lighter in winter.
Nagwa checks depth with a Wood’s lamp at the consult — epidermal melasma responds far faster than dermal, and knowing which you have changes the plan and the price.
Why it happens
Pigment cells that overreact to light, heat and oestrogen
Melanocytes in the affected patches are simply more reactive than the ones beside them. Sunlight is the loudest trigger, but visible light and heat set them off too — which is why a hot kitchen or a long drive can undo careful weeks.
Oestrogen and progesterone raise the baseline, so pregnancy, hormonal contraception and perimenopause all show up in the history. Treating the pigment without controlling the trigger is how people end up with rebound darker than where they started.
1
Protection first — mineral SPF 50 with iron oxides, reapplied, plus shade and a hat.
2
Then suppression — a prescription topical course to quiet the pigment cells.
3
Only then resurfacing, gently and never in July.
What treats it
What we use for melasma, in the order we use it
Prices are starting points. Which of these you need — and in what order — is decided at the consult, in writing.
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The Perfect™ Derma Peel
A layered brightening peel course — four to six sessions, spaced, at a strength your skin type tolerates.
[DEMO]
View treatment
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La Vie’s MOXI ™ Laser Treatment by Sciton
Low-density resurfacing that suits deeper skin tones and runs year-round; used gently and never at full summer.
[DEMO]
View treatment
Also part of the plan
Mineral SPF 50 with iron oxides
Barrier repair routine
Vitamin C every morning
Courses can be paid with Cherry.
Before & after
Our own patients, unretouched
Same light, same lens, same distance every visit. Drag the handle to compare.
In their words
Clients who came in with the same thing
Left on Google, edited only for length.
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Rated 5 out of 5 stars
I came in convinced I needed a laser and left with a prescription cream and a sunscreen lecture. Six months later the patches on my cheeks are the faintest they have been in a decade. They could have sold me three of everything.
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Rated 5 out of 5 stars
Nagwa showed me photographs of clients with my skin tone rather than the brochure ones, and she talked me out of the more expensive option. Two peels in, my makeup sits properly for the first time since my twenties.
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Rated 5 out of 5 stars
The spots on my chest had bothered me for fifteen years. Three sessions, honest warnings about the flaking week, and they are gone. Booking the face and chest together was the right call.
Questions
The things people ask us
If yours is not here, ask it at the consult — or email it and Nagwa answers within a business day.
Will it come back?
Some of it, eventually — melasma is a chronic tendency, not a one-off stain. What changes is how much comes back and how fast: with daily SPF and a maintenance topical, most clients hold their result through the summer and top up once a year rather than starting again.
Can I have laser for melasma?
Sometimes, and carefully. Aggressive heat can make melasma worse, which is why we start with topicals and peels and only add low-density Moxi once the pigment is quiet. If a clinic offers you laser as the first answer for melasma, ask them why.
Is it safe while pregnant or breastfeeding?
Not the prescription topicals or the lasers. What we can do is protect and hold — mineral SPF, azelaic acid, a gentle routine — and start properly once you are done breastfeeding. That conversation is part of the free consult.
What does the free consultation actually include?
Twenty minutes with Nagwa: a proper look under clinic light and magnification, your history and any medications, same-light photographs for your file, and a written plan with prices and an order of operations. No deposit, and no obligation to book anything on the day.
Can I spread the cost?
Yes — courses can be split into monthly payments through Cherry, with plans starting around $45 a month depending on the total. We will show you the monthly figure next to the total before you decide anything.
Related concerns
People with this usually have one of these too
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Age Spots
Flat brown spots with crisp edges on the cheekbones, temples, chest and backs of the hands.
3 treatments
Cumulative sun
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Sun Damage
Blotchy tone, broken capillaries, rough patches and early lines — usually across the face, chest and shoulders together.
3 treatments
Years of UV
-
Uneven Skin Tone
No single spot to point at — just tone that reads patchy, dull and mismatched in daylight or on camera.
3 treatments
Mixed causes
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Freckles
Small scattered spots that darken in summer and fade in winter — treated only if you want them gone.
2 treatments
Genetic + sun
Melasma rewards patience and punishes shortcuts.
Twenty free minutes gets you the depth checked, the trigger identified, and a written plan with prices — including the honest version, which sometimes starts with sunscreen and nothing else.
1,500+ clients · Rochester Hills & Clawson · Cherry monthly plans