Melasma is a skin alteration in the form of brown spots or flat patches with irregular edges, which are darker than the color of the skin. It usually appears on the cheeks, temples, both sides of the forehead, upper lip, nose, and sometimes even the chest.
It especially affects dark phototypes, i.e. the olive complexions characteristic of Mediterranean countries, but also those with a family history of the condition. The disorder carries no health risks, but often creates embarrassment.

Causes of melasma

The causes of this condition are almost unknown, but it is assumed that there is an excessive hormonal stimulation at the base, capable of increasing the activity of the melanocytes, undermining their functionality and inducing an overproduction of the transfer of melanin to the keratocytes of the basal layer or to the macrophages of the dermis. The consequence is precisely the typical hyperpigmentation of dark spots.
Precisely because of the relationship with hormonal imbalances, melasma is often associated with the protracted use of the contraceptive pill, irregular menstrual cycles due to estrogen imbalances and pregnancy – for which it is also called chloasma or “pregnancy mask”.

However, despite the spontaneous nature of this disorder, there are factors and behaviors that can significantly exacerbate it. Exposure to UV rays, for example, accentuates hyperpigmentation: melasma tends to increase, on certain occasions even appearing for the first time, on those people who live in sunny climes or who repeatedly expose themselves with poor protection (if any).

Other aggravating factors are the presence of autoimmune thyroid disease and the intake of some photosensitizing drugs, such as hydantoin for epilepsy.
While melasma tends to disappear and resolve spontaneously at the end of pregnancy, or with the suspension of oral contraception, in all the other cases, in order to be eliminated, it must be systematically treated, also because, over time, it tends to recur.

Melasma treatment

Always engaged in the study of tailor-made protocols, Image Regenerative Clinic specialists have developed different and combined therapeutic treatments for maximum effectiveness to fight melasma. The options include a topical home therapy formulated especially for the patient, associated with one or more of the following solutions:

  • Fraxel laser;
  • Pulsed light as mixed or pigmentary photorejuvenation;
  • Laser Toning with 1064 Qsw – methodical invented in Korea and proposed by Image as an absolute innovation specific for melasma;
  • QSW laser for senile lentigo.

In summary

For whom it is appropriate

The treatment of melasma is especially suitable for people with dark phototypes, but also for those who want to contrast photo and chronoaging in general.


Any age according to the specialist’s indications.


Based on the extent and type of melasma to be treated.

Social return



Fraxel laser, Pulsed Light, Toning laser with 1064 Qws, QWS laser for senile lentigo.

Recommended post-operative treatments

HydraFacial MD is always recommended to restore hydration and enhance the effects of lasers and other treatments.


Image team led by Prof. Carlo Tremolada performs melasma treatments in Milan.


You can view before and after photos of melasma treatments at Image Regenerative Clinic.


View the prices page, or fill out the form to request information about melasma treatments costs.


Can melasma disappear?

No, melasma does not go away, but it can be contained. After its appearance, the only strategy is restraint, associated with coexistence with the problem, which – we remind you – is a hormonal-based pigmentation disorder. So, the only way to deal with it is: “keeping and containing it”.

You can expose the body to the sun, as melasma tends to appear only on the face. But be careful, because tanning can aggravate this problem.

Contact us for more information or to book an appointment

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