Melasma: Causes and Treatments

Expert Medical & Cosmetic Dermatology for Pigmentary Disorders

Dr. Marie Hayag is a board-certified dermatologist specializing in the diagnosis and management of complex pigmentary conditions, including melasma. At her Upper East Side practice, melasma treatment combines medical expertise with advanced light-based technologies, chemical peels, and physician-directed therapies designed to safely improve discoloration while minimizing recurrence. All care is physician-guided, evidence-based, and tailored to support long-term skin health.

A Brief Overview of Melasma

Melasma is a chronic pigmentary disorder characterized by symmetrical brown or gray-brown patches that most commonly appear on the face. The condition is influenced by hormonal changes, ultraviolet exposure, heat, and genetic predisposition, which makes it persistent and prone to recurrence.

Because melasma can worsen without proper management, professional dermatologic evaluation is essential to guide safe, effective, and long-term treatment strategies.

What Is Melasma?

Melasma occurs when melanocytes produce excess pigment in response to internal and external triggers such as hormones, sun exposure, and inflammation. It often affects the cheeks, forehead, upper lip, and jawline and may vary in depth, making treatment more complex than other forms of hyperpigmentation.

Accurate diagnosis by a board-certified dermatologist is critical, as melasma can resemble other pigmentary disorders and requires specialized, long-term management strategies.

What Triggers Melasma?

Melasma often develops when multiple triggers stimulate melanocytes to produce excess pigment. The most common triggers include sun exposure, hormonal fluctuations such as pregnancy or birth control use, heat, inflammation, and genetic predisposition. Because these triggers vary between individuals, identifying and managing them is an important part of long-term melasma treatment.

Melasma Treatment Options

Melasma treatment often requires a carefully customized combination of therapies. Certain light and laser treatments can improve pigment irregularities when used conservatively under physician supervision, while others may worsen melasma if used improperly. For this reason, all treatments are selected and performed based on an individualized dermatologic evaluation.

Medical Melasma Therapy

Definition:

Dermatologist-prescribed topical and oral therapies designed to suppress melanin production, reduce inflammation, and stabilize pigment activity.

What it helps with:

Reduces excess pigment production, inflammation, and discoloration while supporting long-term maintenance.

Who it’s ideal for:

Foundational treatment for most melasma patients and ongoing pigment control.

Medical Melasma Therapy

Chemical Peels

Definition:

Medical-grade exfoliating solutions that resurface the skin and regulate pigment activity.

What it helps with:

Lightens hyperpigmented patches, improves texture, and enhances absorption of medical therapies.

Who it’s ideal for:

Patients with superficial melasma or those seeking gradual pigment improvement.

Chemical Peels

Clear and Brilliant Laser (Selective Use)

Definition:

A gentle fractional laser promoting skin renewal and collagen stimulation. This service must be performed strictly by trained professionals and consultation is essential.

What it helps with:

Improves texture and tone in carefully selected melasma patients under strict physician supervision.

Who it’s ideal for:

Patients with texture concerns alongside melasma.

Clear and Brilliant Laser

BBL Hero IPL

Definition:

BroadBand Light High Energy Rapid Output (BBL HERO) targets pigment irregularities and stimulates skin rejuvenation.

What it helps with:

Reduces diffuse pigmentation and sun spots while supporting overall skin clarity.

Who it’s ideal for:

Patients with superficial to moderate melasma and sun-damaged skin.

BBL Hero IPL

Vbeam

Definition:

Pulsed dye laser targeting vascular components that may contribute to pigment variation.

What it helps with:

Improves redness and vascular pigmentation that can exacerbate melasma appearance.

Who it’s ideal for:

Patients with combined pigment and vascular concerns.

Vbeam

Aerolase Neo Elite

Definition:

Gentle laser technology for multiple pigment and texture concerns.

What it helps with:

Reduces pigment, improves texture, and supports skin renewal with minimal irritation.

Who it’s ideal for:

Patients with sensitive skin or those prone to irritation.

Aerolase Neo Elite

Fraxel

Definition:

Fractional laser resurfacing stimulating collagen and skin renewal.

What it helps with:

Targets deeper pigmentation and uneven skin texture.

Who it’s ideal for:

Patients with carefully evaluated pigment depth who may benefit from controlled fractional resurfacing under physician supervision.

Fraxel

Miria by AVAVA

Definition:

Advanced laser technology targeting deeper skin layers to improve pigmentation and stimulate collagen.

What it helps with:

Refines skin texture and reduces pigment while promoting overall skin health.

Who it’s ideal for:

Patients with persistent or complex melasma.

Miria by AVAVA

Medical Facials

Definition:

Dermatologist-directed treatments that cleanse, exfoliate, and nourish skin.

What it helps with:

Supports pigment management, enhances clarity, and complements other melasma therapies.

Who it’s ideal for:

Patients seeking maintenance care alongside medical or laser treatments.

Medical Facials

PicoWay Laser

Definition:

PicoWay is an FDA-cleared picosecond laser that uses ultra-short pulses of energy to treat pigmentation, acne scars, fine lines, and unwanted tattoos in a physician-led setting.

What it helps with:

PicoWay breaks pigment and tattoo ink into tiny fragments the body clears naturally and stimulates new collagen production, improving tone, texture, and clarity with minimal downtime.

Who it’s ideal for:

Ideal for patients dealing with sun spots, melasma, acne scarring, fine lines, or an unwanted tattoo, especially those with skin tones that made other lasers feel too risky.

PicoWay Laser

Am I a Good Candidate for Melasma Treatment?

You may be a good candidate if you:

  • Have brown or gray-brown facial patches that worsen with sun exposure
  • Experience pigmentation triggered by hormonal changes
  • Have persistent discoloration despite over-the-counter products
  • Are committed to strict sun protection and long-term maintenance

Because melasma requires individualized management, a consultation with a board-certified dermatologist is essential to determine the safest and most effective approach for your skin type and pigment depth.

What to Expect During Treatment & Recovery

Treatment typically involves a combination of in-office procedures and at-home medical therapies. Chemical peels and laser treatments may cause temporary redness or mild sensitivity. Medical therapies require consistent application over months for full effect.

Strict sun protection is crucial during treatment and maintenance to prevent recurrence. Improvement occurs gradually as pigment stabilizes and inflammation decreases.

Why Choose Marie Hayag, MD for Melasma Treatment?

Patients benefit from:

  • Board-certified dermatologic expertise
  • Accurate pigment depth assessment
  • Customized treatment plans for all skin types and tones
  • Conservative, evidence-based use of light and laser technologies
  • Long-term strategy focused on pigment stabilization and skin barrier health

This physician-led approach ensures safe, effective, and natural-looking improvement while prioritizing long-term skin integrity.

Expert Melasma Management Begins with Precise Dermatologic Evaluation

Melasma can resemble other pigmentary disorders, making accurate diagnosis essential. At Marie Hayag MD, care begins with a comprehensive, physician-led evaluation to assess pigment depth, triggers, and skin characteristics.

This evaluation allows for safe treatment selection and personalized care designed to manage melasma effectively while minimizing recurrence.

To schedule your appointment, please call 212-722-2055 or book online. Our Upper East Side dermatology practice proudly serves patients throughout Manhattan and New York City.

Refined Dermatology, Aesthetic, And Regenerative Care

Excellent rating
Based on 110 reviews
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Dr. Hayag has been my excellent dermatologist for more than 20 years! I won’t reveal my secrets but I will recommend her highly!
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Phyllis Lee
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I had an amazing experience with Dr. Hayag! I went in for a preventative skin check and botox. She is incredibly thorough, knowledgeable, and precise. I can't wait for my next visit!
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Rachel Ancel
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Dr. Hayag has been my dermatologist since I was young, and I truly cannot recommend her highly enough. She treated my acne when I was younger, and I have continued to see her over the years for any skin concerns that come up. She is always incredibly thorough, knowledgeable, and caring, and I completely trust her. On top of that, her entire staff is so warm, kind, and lovely, which makes every visit such a positive experience. I’m so grateful to have had her as my dermatologist for so many years.
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Katie
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Landy Aguiar
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My entire family has been seeing Dr Hayag for over a decade for general dermatology. She’s extremely knowledgeable and provides the best level of care and advice. She’s been equally good for my kids as teens and young adults, focusing on prevention and healthy skin habits. The entire staff is kind and friendly, keeps appointments on time and has great communication. I’m a patient for life - a wonderful doctor and practice.
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Patricia Falconi
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Dr. Hayag is an amazing doctor. Very caring and gentle with her patients. I have been with her for years and will continue to be with her. I highly recommend her.
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Ann Nellissen
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Everyone in the office is so kind and sweet to me I appreciate how they take their time to address my concerns
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mimi chung
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My visit to Dr. Hayag’s Office was superb. No waiting, lovely professional help and Dr. Hayag with an easy confident manner, artistic eye and quick hands managed to make my experience the best ever. I’m so grateful to be in her care.
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mary Conley
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⭐️⭐️⭐️⭐️⭐️ Dr. Hayag is an extraordinary dermatologist whose expertise, compassion, and commitment to excellence are unmatched. I have been under her care for over 15 years, and she remains the only dermatologist I trust implicitly. I travel from out of state, over two hours each way for my appointments, which speaks volumes about the caliber of her care. Dr. Hayag’s mastery of dermatology is second to none. She stays at the forefront of innovation, continually advancing her practice by attending leading dermatology conferences and incorporating the most cutting-edge techniques and treatments. Yet what truly distinguishes her is not just her knowledge, but her humanity. She takes the time to listen, to educate, and to ensure her patients feel understood and empowered in every decision. Her genuine care and personal attention are evident in every interaction. She is meticulous, insightful, and wholly dedicated to achieving the best outcomes for her patients. Her office reflects her professionalism and taste, immaculate, serene, and inviting. Her staff embodies the same warmth and excellence she brings to her work, creating an environment that feels both luxurious and deeply personal. Dr. Hayag represents the gold standard in dermatology: exceptional skill, unwavering integrity, and a sincere devotion to her patients’ well-being. I highly and wholeheartedly recommend her to anyone seeking the very best in dermatologic care.
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Mary Ann M
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My favorite mult-generational doctor! A long-time patient, I trust her judgment and skills so much that I've sent my daughters to Dr. Hayag too!
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Bee-Ann Benson

Your Care Begins With A Conversation

Frequently Asked Questions

What causes melasma?-+

Melasma is triggered by hormonal changes, sun exposure, heat, and genetic predisposition.

Is melasma permanent?-+

Melasma is chronic but can be managed effectively. Without treatment and maintenance, recurrence is common.

Can laser treatments make melasma worse?-+

Certain lasers can worsen melasma if not carefully selected. Physician guidance ensures safety.

Is melasma treatment safe for all skin tones?-+

Yes. Treatments are customized to ensure safety across all skin types.

How long does melasma treatment take?-+

Improvement occurs gradually over several months with consistent treatment and strict sun protection.

Can melasma go away on its own?-+

Melasma rarely disappears completely without treatment. While pigmentation may fade during periods of lower sun exposure or hormonal changes, it often returns. Dermatologist-guided treatment and consistent sun protection help control melasma and prevent worsening.

Expert Melasma Management Begins with Precise Dermatologic Evaluation

Melasma can resemble other pigmentary disorders, making accurate diagnosis essential before treatment begins. At Marie Hayag MD, melasma care starts with a comprehensive, physician-led evaluation to assess pigment depth, contributing triggers, and individual skin characteristics.

This precise assessment allows for safe treatment selection and personalized care designed to manage melasma effectively while minimizing recurrence.

Schedule your consultation at Marie Hayag, MD to receive personalized, evidence-based care for melasma and complex pigmentation concerns.

Call 212-722-2055

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