What Is Melasma and What Causes It?

Melasma is one of the most complex and, honestly, one of the most emotionally frustrating skin concerns we treat. It shows up as patches of brown or grey-brown discolouration — usually on the cheeks, forehead, upper lip, and chin — and is driven by hormonal shifts, sun exposure, heat, genetics, and inflammation.

It’s often called the “pregnancy mask” because pregnancy hormones are one of the most common triggers, but melasma also shows up with birth control use, hormone therapy, thyroid conditions, and simply from cumulative heat and sun exposure over time. It’s more common in women and in those with medium-to-deeper skin tones, and it rarely responds to over-the-counter brightening creams alone, because melasma sits deeper in the skin than surface hyperpigmentation from acne marks or sun spots.

This is also why melasma treatment in Surrey BC needs a different, more careful approach than treating a sun spot or a single dark patch. The wrong laser settings, the wrong heat level, or an overly aggressive protocol can actually trigger more pigmentation rather than less — a phenomenon called rebound hyperpigmentation. At Uptown Skin & Laser Clinic, we take a medically guided approach to melasma, always calibrated to your specific skin tone, melasma pattern, and treatment history.

Melasma & Pigmentation Treatments We Recommend

Treatment Why We Recommend It For This Concern
PicoSure Pro Our first-line melasma laser for most patients. Picosecond technology generates less heat than older lasers, reducing the risk of rebound pigmentation that can worsen melasma — especially important for medium and deeper skin tones.
Lase MD Ultra A gentler resurfacing laser that can be paired with brightening serums infused directly into the skin via its drug-delivery capability, supporting pigmentation correction with minimal downtime.
Micro Needling Supports collagen remodelling and improves topical brightening product absorption — often used between laser sessions as part of a longer-term melasma management plan.
Q Switch Laser An alternative pigmentation laser for specific patterns and patients where wavelength targeting is a better fit, used with more conservative settings on deeper skin tones.
Chemical Peel Mandelic acid and other gentle peel formulations support pigmentation fading and are often used as a maintenance step between energy-based treatments.
Radiance Glow Facial A non-laser brightening option using medical-grade actives — a good entry point if you're not ready for laser, or as ongoing maintenance once melasma is under control.

Benefits of Melasma & Pigmentation Treatment

  • Visibly lighter, less intense pigmentation patches
  • A more even, balanced, naturally luminous skin tone
  • Lower risk of recurrence with consistent SPF and maintenance
  • Safe, effective treatment across all skin tones, including Fitzpatrick IV–VI
  • A management plan, not just a one-time treatment
  • A protocol that adapts as your skin responds

Results You Can See

Pigmentation treatment typically needs 4–8 sessions spaced 4–6 weeks apart, with results developing progressively as the body clears treated pigment between sessions.

Frequently Asked Questions

Can melasma be cured permanently?
Melasma is a chronic condition — it can be significantly reduced and kept under control, but the underlying tendency usually remains. With the right in-clinic protocol, daily SPF 50+, and periodic maintenance, many patients keep their skin clear long term. We are honest in consultation and do not guarantee permanent cures.
Is PicoSure Pro safe for melasma on darker skin tones?
PicoSure Pro is one of our preferred options for melasma in diverse skin tones because picosecond technology produces less heat than older lasers, lowering the risk of rebound pigmentation. Every protocol is customized based on Fitzpatrick skin type.
What triggers melasma to come back after treatment?
Sun exposure, heat, hormonal changes (including pregnancy and birth control), and skipping SPF are the most common triggers. That’s why treatment always includes maintenance and prevention planning, not just initial correction.
Why do some treatments make melasma worse instead of better?
Melasma is highly sensitive to heat and inflammation. Overly aggressive lasers, strong peels, or irritation can stimulate pigment cells instead of calming them. This is why a conservative, staged approach is essential for safe treatment.
How is melasma different from regular dark spots or sun spots?
Sun spots are usually smaller, more defined, and closer to the skin surface, so they respond faster. Melasma is typically larger, more diffuse, deeper, and hormonally influenced, requiring longer-term management and maintenance.
Ready to Address Your Melasma & Pigmentation?
Book a consultation at Uptown Skin & Laser Clinic in Surrey, South Surrey & White Rock. Every plan starts with a thorough skin assessment — built around you.
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