Concerns We Treat
Melasma
Patches of deeper pigment, often brought on by sun and hormones, settling in symmetrical maps across the face.
Patches of deeper pigment, often brought on by sun and hormones, settling in symmetrical maps across the face.
Melasma is a particular kind of pigmentation, settling in soft symmetrical maps across the face, most often the cheeks, the forehead, the upper lip, and sometimes the jawline. Unlike the discrete brown spots of ordinary sun damage, it appears as broader patches with diffuse edges, and unlike most surface pigment, it is closely tied to hormonal activity in the body as well as to sunlight on the skin.
It is also notoriously sensitive to treatment. Where ordinary sun damage often answers cleanly to laser work, melasma can deepen when the wrong laser is used or when energy is set too aggressively. This is the concern that asks most for restraint, patience, and treatment chosen by the depth and behavior of the pigment rather than by what works elsewhere on the same face.
Treatment at Refined Aesthetics suits the patient whose melasma is bothersome enough to address and who is ready to commit to the patient daily care that makes any in-clinic work last. The work is gradual and accumulative, and the home routine matters at least as much as the appointment.
It also suits patients ready to think of melasma as a condition to manage rather than to cure. The pigment-producing cells remain sensitized, and the practical aim is to lighten what has surfaced and keep new pigment from being made. That is real and meaningful work. It is not the same as making melasma vanish.
Melasma arises from the meeting of two forces, neither of which alone explains the pigment fully. Sunlight stimulates the cells that produce pigment, prompting them to do their protective work. Hormones, particularly the cyclical and elevated hormones of pregnancy, the contraceptive pill, and certain stages of perimenopause, sensitize those same cells to respond more strongly to less light. The combination produces pigment in patterns and quantities that ordinary sun exposure alone would not.
Genetics decides predisposition. Skin of color is more often and more visibly affected, and patients with family histories of melasma carry the predisposition forward. Heat, even without direct sun, can deepen the pigment, which is why melasma so often surfaces or worsens during summer regardless of careful avoidance of bright light.
You may notice:
Melasma is a relapsing condition more than a one-time event. It can arrive in the twenties and thirties, often with pregnancy or hormonal medication, and it can persist for years or for decades, lightening and deepening cyclically with hormonal shifts, with the seasons, and with sun exposure.
The arc is not a steady progression but a pattern of flare and fade. The work of meeting it is similarly patient. Treatment is rarely complete, in the sense that an ordinary brown spot can be entirely lifted; it is ongoing, in the sense that the pigment-producing cells remain sensitized and the daily care that prevents recurrence is as much the work as any treatment in the chair.
I’ve been seeing Sarah Safa for over 10 years. Sarah and her team provide the best quality and service in the industry. I highly recommend Refined Aesthetics!
LOVE this place!! Everyone is very friendly and down to earth and the services are out of this world! I see Amanda for all my services and she is absolutely amazing. Highly recommend!! Do yourself a favor and get quality over quantity! The prices are actually super fair though and they have a great membership plan that gives you discounts!
Sarah is the ultimate professional. She knows her craft and cares about everyone of her clients. I highly recommend her and wouldn’t go to anyone else.
