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We always strive to obtain clear skin, but it is not always easy to do, especially in areas with high UV radiation. Among the many things that keep us from obtaining blemish-free skin is melasma, a stubborn condition that causes dark spots to appear on our faces. Its chronic nature and multitude of triggers make it all the more difficult to handle, which means it should be treated to be kept under control. 

To address melasma, you’ll have to fully understand its roots. The condition is different from other forms of hyperpigmentation, which means a specialized approach is the key to addressing it. 

What Is Melasma?

SMelasma is a commonly occurring skin pigment condition that causes small brown and sometimes grayish spots to appear in concentrated patches on the face. The issue is neither dangerous nor life-threatening, but of all the skin conditions most often seen by dermatologists, melasma is one of the most stubborn and pervasive. These spots can quickly change the overall look and complexion and detract from an individual’s personal and professional image.

Melasma is caused by melanocytes (pigment producing skin cells) producing excess melanin, usually due to sun damage or inflammation. The condition can also be triggered by hormonal changes, which is why it’s so common in pregnant women or those taking birth control. Visible light, heat, and UV exposure can worsen the condition, which is why it should be treated as soon as possible.

How Is Melasma Diagnosed?

Melasma is different from most forms of hyperpigmentation, so it’s essential to diagnose it correctly. Dr. Ostad will perform a physical examination to diagnose the condition, looking at the most common areas for melasma. During this time, he will look for symmetrical, brownish, blotchy patches of pigmentations, these patterns usually suggesting melasma.

A Wood’s lamp (or a black light device) is often used to see the changes in your skin color. This should help determine how deep the pigmentation goes, establishing if you have epidermal, dermal, or mixed melasma. Your medical and family history will also be considered to see the cause of your melasma.

Aside from the skin surface assessment, you might also be checked for thyroid disorders. Often, thyroid diseases can lead to hormonal imbalances, which can end with hormonal melasma.

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Common Treatment Areas

Melasma can appear in various areas of the face and body, but it’s more common in the cheeks, forehead, nose, and area around the lips. For the most part, the areas that get the highest UV exposure, such as the cheeks and forehead, can get these patches, but hormonal imbalances can also cause them to form around the upper lip. Aside from the face, melasma can appear in different areas, including:

  • Neck: While not as common, it can appear in those with darker skin tones who get repeated UV rays exposure.
  • Arms: Also quite rare, melasma can show up on the forearms due to significant exposure to the sun.
  • Shoulders: Particularly common in those who frequently wear strapless or sleeveless clothing, as one’s shoulders are the most likely to be hit by UV rays.

If you have areas that are predisposed to melasma, it’s recommended that you take the necessary precautions. Stay inside during peak sun hours, use sunblock as directed, and wear protective clothing and hats to keep the UV rays at a distance.

Personalized Treatment Plans

Customized Consultations

Depending on how extensive your melasma is and the root cause of your condition, a customized plan might be required to bring it under control. Dr. Ostad offers personalized consultations to determine which path works best for your needs. Your skin’s needs will be taken into account, choosing a variety of treatment combinations to restore balance and create a smoother skin tone.

Melasma Treatment Process

Melasma may occasionally fade on its own over time. Still, it is also treatable through various options ranging from topical lightening agents such as Vitamin C, Azelaic Acid, Retinoic Acid, Trichloroacetic acid, Cyspera, Hydrochloric Acid to other topical depigmenting agents. In addition, in our practice, we perform a variety of chemical peels to improve melasma. Few sessions are required to achieve optimal results. Additionally, lasers such as PicoWay® laser or Fraxel® laser can be beneficial.

The treatment process for melasma is often personalized based on the patient’s needs, as the condition might vary from one individual to the other. That said, Dr. Ostad also goes through some standard steps to ensure the best results. Here is what you can expect: 

Initial Consultation: Dr. Ostad will perform an initial skin assessment to identify the extent of your melasma. Visual assessments and digital imaging might be used to determine whether or not the pigments have reached the dermis. 

Skincare Selection: Gentle yet effective medical-grade skincare will be selected to ensure the improvement of skin quality. Dr. Ostad will focus on active ingredients like arbutase, kojic acid, azelaic acid, tranexamic acid, and tretinoin to help even out your skin tone. 

In-Office Treatment: Aside from the medical-grade skincare, Dr. Ostad might also choose to perform an in-office treatment to reduce and treat symptoms of melasma. Based on your goals and skin tolerance, Dr. Ostad might use laser therapy, chemical peels, or microneedling to improve your skin quality.

Lifestyle Adjustment Advice: Since melasma can return even with treatment, Dr. Ostad will offer some suggestions to adjust your lifestyle. He can advise you on performing your skincare, taking internal treatment, and protecting yourself from UV rays.

There is no downtime associated with melasma treatments. Some patients who undergo chemical peels and/or laser treatments may experience redness and swelling for a few days, but that will dissipate quickly. Because of the quick nature of the process, treatments can be performed over a long lunch break. Regular activities can be resumed immediately after.

One thing to remember is that while treatment can reduce the intensity of the melasma, it won’t prevent the condition from rearing its head again. We recommend that you take the necessary steps to avoid it, such as using sunblock. Formulas containing iron oxide are particularly effective against melasma, especially the kind induced by UV rays.

Benefits of Melasma Treatments

Reduction of Inflammation

Melasma treatments such as prescription medicine or chemical peels can reduce inflammation. By calming and strengthening the skin, no unnecessary damage will further occur, regulating the melanin production and evening out your complexion.

Reduction of Melanin Formation

When the melanin clusters have already been formed, melasma treatments can help break them and improve skin clarity. For instance, laser treatments can break the melanin bonds to the healthy cells, prompting the immune system to gradually remove the pigment. Procedures like chemical peels also trigger the removal of the top layer of the skin, revealing the healthy cells underneath.

Enhanced Skin Radiance

Melasma treatments can also improve skin radiance by creating a more uniform, rejuvenating complexion. The right procedure not only breaks down the pigment but also strengthens the skin barrier to promote a healthy look. Laser treatments and chemical peels reduce the size of your pores, improving skin texture and reducing acne incidence. When the treatment is finished with the proper medical-grade skincare, the surface can look dewy and rejuvenating, offering a beautiful long-term glow.

Reduction of Broken Blood Vessels

Some procedures frequently used to break pigment clusters (e.g., Fraxel® and Cutera lasers) can also constrict the blood vessels that are responsible for excess redness. While this may not be their main purpose, it can help those with mild redness improve their skin tone, removing the need to wear as much makeup. 

Longer-Lasting Results

Melasma can be stubborn, even if you avoid the sun or use top-notch OTC skincare. By getting personalized melasma treatment, you can prevent its recurrence and keep your skin smooth for longer. Plus, by getting melasma treatments like laser or microneedling, you can enjoy long-lasting results, especially when you follow up with maintenance treatments.

Reduced Signs of Aging

The treatment of melasma employs a series of skin-resurfacing procedures that trigger your body’s healing response. The body will send the signal to produce new collagen in the area to aid the healing process. This helps reduce various age-related concerns like wrinkles, fine lines, and mild skin sagging, rejuvenating your appearance.

Before & After

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Managing Melasma is a gradual process and results may vary from person to person. We treated this patient with a series of 2 Fraxel laser treatments so far and her results are amazing!

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3 sessions spaced one month apart are recommended to see optimal results. This patient had 1 session of Fraxel so far and will continue to see improvement with her next 2 treatments!

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Reviews

Melasma Treatment for Medical Conditions

Beyond Cosmetic Uses

For the most part, melasma is considered harmless, with most people using the treatments for cosmetic purposes. That said, certain treatments, especially the internal type, can also help manage medical conditions. For instance, if the melasma was caused by hormonal imbalances, the right prescription treatment can help create a balance and improve your well-being. If you have recurring skin disorders, most melasma treatments can also improve the function of your skin barrier, promoting better health.  

Success Stories

“I have been to other well known dermatologists and can compare different doctors. Dr. Ostad spent enough time with me to answer my questions and explain the procedures. He is kind, serious, and professional. I have sensitive skin and bruise easily. The injections were so skillfully done that there was minimal swelling and no redness.” – Anonymous 

“I have been going to Dr. Ostad for more than 25 years. Even after moving from NYC to CT, I incurred the inconvenience of taking the train into the City to see him because I could not find the same level of care in CT that I experienced with Dr. Ostad. He has performed Mohs surgery on my forehead and other areas, as well as some cosmetic surgery, all with excellent results. Simply put, I feel I am getting the best care available with Dr. Ostad.” – Joseph M.

Frequently Asked Questions

Who Is a Good Candidate for a Melasma Treatment?

Men and women who are experiencing stubborn hyperpigmentation issues are likely candidates for melasma treatment and will benefit from our services. Ninety percent of people who develop melasma are women, and the condition is triggered primarily due to hormonal changes. Birth control pills, pregnancy, hormone therapy, and anything that elevates or alters estrogen or progesterone levels are likely to produce this harmless but unwanted condition. Sun exposure is also responsible for melasma.

When Will I See the Results of the Melasma Treatment?

Patients will notice a change in their skin after about three months. Treatment results create an overall evening out and beautify the complexion. Because melasma is one of the most stubborn skin conditions seen by skincare professionals, topical creams and vitamins may fall short of making lasting and noticeable changes.

What Can I Do to Prevent Melasma Recurrence?

Sun exposure is often the triggering factor for melasma, and excessive UV rays stimulate the pigment-controlling cells. Patients must use SPF and wide-brimmed hats to protect their skin from the sun and keep their melasma at bay. A combination of sunscreen use, topical brightening, and lightening agents, along with chemical peels and lasers, can improve melasma.

Can I Treat My Melasma with Laser Even If I Have Dark Skin?

While patients with darker skin are recommended to go with gentler treatments, recent advancements have also made it possible for you to use lasers. Dr. Ostad can adjust the intensity of the laser procedure to ensure efficiency while maintaining the highest degrees of safety.

How Long Will I Be Able to Enjoy the Results?

The results from a melasma treatment have the potential to be permanent, but only if you are thorough with your maintenance. It is recommended to come back into the office every six to 12 months, depending on the treatment used. Apply your recommended skincare as instructed and protect the skin against UV exposure.

About. Dr. Ostad

Dr. Ostad is a board-certified dermatologist with his own practice in New York, on the Upper East Side of Manhattan. With more than two decades of experience in his domain, he is known for using minimally invasive treatments to reduce pigmentation issues, melasma included. Offering personalized treatment plans for his clients, he has helped numerous patients achieve their cosmetic goals, offering the highest standards of care. Dr. Ostad uses only the latest technologies to ensure the best results with as little discomfort to the patient as possible.

Melasma treatments are available at Dr. Ostad’s practice in New York, where he offers top-quality care and customized treatment plans.

Have More Questions?

If you have any questions that have not been addressed in this FAQ, feel free to get in touch with our team at any time. We are dedicated to offering the best quality advice and treatments so that you can make the right decision for your skin.

Expert Answers

Can melasma come back after treatment?

Yes, melasma can recur, especially if the triggers (like sun exposure or hormonal changes) are not managed. Maintenance treatments and consistent sun protection are key to preventing recurrence.

Is melasma the same as sun damage?

No, melasma is different from sun damage, although sun exposure can worsen melasma. Sun damage often leads to age spots or an uneven skin tone, while melasma is characterized by larger, more uniform patches.

Does melasma affect people of all skin types?

Yes, but it is more common in people with medium to darker skin tones due to their higher melanin content. It is also more prevalent in women than in men.

How long does it take to see results from melasma treatments?

Results vary, but many patients start noticing improvement within 4-12 weeks of consistent treatment. Laser treatments or chemical peels may provide faster results but often require multiple sessions.

Combining Melasma Treatment with Other Procedures

Treatment Combinations

While there is no official treatment for melasma, the combination of different procedures might yield good results in improving the quality of your skin. One of the most common treatments for melasma is a chemical peel, which removes the upper layer with excess melanin. Dr. Ostad might choose to combine the procedure with microneedling to increase medical-grade absorption.

Laser therapy targeting melanin clusters like Fraxel® or picosecond lasers can also be used to gradually reduce melasma, especially in sensitive skin. To rejuvenate the skin and speed up the removal of damaged cells, Dr. Ostad might recommend Platelet Rich Fibrin Matrix (PRFM) treatments as a complementary procedure. The growth factors from your own blood boost the resurfacing of healthy cells and reduce melanin production from melanocytes.

Comprehensive Rejuvenation

Melasma is quite a complex condition, so a holistic treatment approach is recommended to keep it under control. By combining the right complementary treatments with lifestyle adjustments, you can significantly improve your skin’s appearance. At our office, we offer niacinamide pills which help maintain the skin barrier to increase the production of collagen and ceramides.  They work by inhibiting the transfer of melanin from melanocytes to keratinocytes, reducing pigmentation and preventing new dark patches from forming. Niacinamide also helps fade existing discoloration by regulating pigment production, promoting a more even skin tone over time. Niacinamide pills can take eight to 12 weeks to show results. With the right combinations, you not only address the pigment patches but signs of aging and rough texture as well. 

It’s important to remember that the treatment of melasma is a gradual process that takes patience, care, and ongoing sessions. No matter how long you’ve been dealing with this condition, we can take all the necessary steps to ensure optimal results. Whether you want to go the medical-grade skincare route or prefer chemical peels or lasers, we have all the right recommendations for your needs.

Latest Trends and Innovations

Advanced Techniques

Melasma treatments continue to evolve, with cutting-edge technologies offering the best results with minimal damage to the skin. Adjustable laser procedures can keep the risk of post-inflammatory hyperpigmentation at a minimum, making them suitable even for darker skin tones.

The microinfusion of brightening agents can also improve the efficiency of melasma treatments nowadays, with microneedling used to deliver the product. Dr. Ostad employs specialized tools to create microchannels in the skin, creating a path for the brightening serums to enter. This helps stimulate collagen production while improving the final results. 

Innovative Uses

Nowadays, melasma treatments are not only used to reduce the appearance of current melasma but also to prevent it from appearing. For instance, if you have a history of dark spots on your skin, melasma treatments can improve the skin barrier and keep it looking smooth. These procedures are also frequently used to diminish sun damage, leading to a more youthful appearance.

Safety and Expertise

Why Choose Dr. Ariel Ostad

Dr. Ariel Ostad is one of the few cosmetic providers in New York to hold a triple certification, dealing with numerous medical and cosmetic skin concerns. Thanks to his skills and successes, he has received multiple awards and honors, being labeled as a professional and leader in his field by numerous institutions.

Dr. Ostad is not just a highly skilled professional but also a mentor, passing his knowledge on to residents. His involvement and mentorship led him to be named New York’s surgical attending of the year, all thanks to his expertise and patience.

List of Credentials: 

  • Triple Board Certification in Mohs Surgery, Cosmetic Dermatology, and Facial Cosmetic Surgery
  • Top Specialist for Treatments of Melasma
  • Trained at Harvard, UCLA, and NYU
  • “NYU Dermatologic Surgical Attending of the Year,” 3-Time Recipient
  • New York Super Doctor (2014-2024)
  • Top Doctor, Listed by Castle Connolly (2012-2024)
  • Mentor for Residents and Clinical Associate Professor at NYU Department of Dermatology

Commitment to Safety

When Dr. Ostad created his practice in New York, he aimed to bring comfort and care to his patients. For that to happen, he makes the practice aesthetically pleasing and maintains strict standards of safety, sanitation, and cleanliness.

Since starting his career, Dr. Ostad has invested in numerous advanced therapeutic devices such as lasers and microneedling tools, which he uses to treat melasma. Dr. Ostad constantly updates that technology as it improves, keeping everything current at his practice. The office is authorized by the AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) to function as a surgical facility.

Awards and Certifications

Latest Blog Posts

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What Is Melasma? Symptoms, Treatment Options, and Who Is a Candidate

Melasma is a condition that affects many women, especially those who have frequent exposure with UV rays.

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Dr. Ariel Ostad has seen patients for this service, including BOTOX in NYC, from all over the tri-state area, including Manhattan, Midtown, the Upper East Side, the Upper West Side, Brooklyn, New York City, the Bronx, Harlem, Astoria, Queens, Long Island, New Jersey, Connecticut, and more. If you are interested in any of the services offered at the Office of Dr. Ariel Ostad, please contact us for more information.

BOTOX in NYC Doctor - Dr. Ariel Ostad

Medical-grade skincare products that will help maintain and enhance your results

These skincare products combined with your treatment plan customized by Dr. Ostad will help enhance your results and improve your overall skin texture. Click on a product below to learn more.

ADVANCED LUMA CREAM

ADVANCED LUMA CREAM
CEG + FERULIC COMPLEX

CEG + FERULIC COMPLEX
KOJI BRIGHTENING PADS

KOJI BRIGHTENING PADS
Hyla Complex

Hyla Complex
GENTLE RETINOL COMPLEX

GENTLE RETINOL COMPLEX
Sun Shade Clear

Sun Shade Clear

Dr. Ariel Ostad has seen patients for this service from all over the tri-state area, including Manhattan, Midtown, the Upper East Side, the Upper West Side, Brooklyn, New York City, the Bronx, Harlem, Astoria, Queens, Long Island, New Jersey, Connecticut, and more. If you are interested in any of the services offered at the Office of Dr. Ariel Ostad, please contact us for more information.

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