Hyperpigmentation, Dark Spots & Melasma

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Can melasma be treated?

Yes. Melasma can often be improved and managed, although there is no permanent cure. Some areas may lighten more than others, and recurrence is common. Treatment takes time, so I discuss what improvement may realistically look like and what you can do to help maintain it.

The plan often combines sun protection, carefully selected skincare, and follow-up. A procedure may help a suitable patient, but irritation can also worsen pigment or leave an area lighter than the surrounding skin. Your skin’s response guides the pace of care.

What might your plan include?

Your plan may involve one or more of the following, introduced when appropriate:

• Skincare and prescription treatment. Depending on your assessment, options may include vitamin C, niacinamide, azelaic acid, kojic acid, tranexamic acid, tretinoin, or hydroquinone. I may prescribe a personalized compounded cream when a standard product does not meet your needs. For certain cases of facial melasma, a short course of triple-combination prescription treatment, such as Tri-Luma, may be considered.

• In-office care. A carefully selected chemical peel may help some forms of surface discoloration. Hydrodermabrasion, T-Shape 2 Facial, microneedling, and NeoGen PSR may be considered for other concerns identified during your examination, including texture, acne scarring, or overall skin quality. These procedures are selected with your pigment risk in mind.

I also teach you when to use active skincare, when to pause it before or after a procedure, and how to recognize irritation. If you are pregnant, planning pregnancy, or breastfeeding, tell me before starting a prescription or active product so we can review suitable options.

Sun protection that fits real life

Sun protection is the foundation of melasma care and remains important after discoloration improves. I recommend a broad-spectrum sunscreen with SPF 30 or higher. For melasma, a tinted sunscreen containing iron oxides offers additional protection against visible light. A hat, shade, and regular sunscreen reapplication when you are outdoors are useful parts of the routine.

Daylight can reach your skin through a window. If you spend time driving or sitting beside a sunlit window, daily protection still matters.

Makeup can be helpful, too. A tinted foundation may conceal patches while treatment has time to work, and some formulas contain SPF and iron oxides. I generally recommend applying sunscreen first, then foundation, because makeup is often applied too sparingly to provide the full protection stated on its label. Feeling comfortable in your skin during treatment matters.

If dark spots appear after a procedure

Let me know if you notice new or worsening discoloration after a peel, microneedling, laser, or another skin treatment. I can assess how your skin is healing before adjusting your products or considering another procedure. Starting strong exfoliants or pigment treatments too soon can add irritation.

PIH may fade over months, while deeper pigment can take longer. We will reassess your progress and adjust the plan as your skin responds.

When a skin concern deserves a closer look

Your skin can sometimes reveal a pattern that calls for medical evaluation. Persistent acne together with irregular periods, new facial hair, scalp hair thinning, or darker, velvety skin around the neck or body folds may warrant assessment for polycystic ovary syndrome (PCOS), insulin resistance, or another condition.

These findings alone do not establish a diagnosis. When appropriate, I may recommend targeted lab work or further medical follow-up as part of understanding the whole picture.

Begin with an assessment

Your skin has its own history. Schedule a consultation at Atrium Aesthetics in Chico, and we’ll build a plan around it.