Comprehensive Dermatological Solutions

Dr. Alissa Lamoureux, DO, FAOCD, FAAD, at Skin Dermatology in Shrewsbury, Massachusetts, utilizes multiple different treatment plans from oral medications, topical creams, SkinMedica Peels to our revolutionary PiQo4 Laser.

PiQo4 Fractional Video

PiQo4 Fractional

What is Melasma?

Melasma is a chronic skin disorder that results in symmetrical, blotchy, brownish facial pigmentation. Melasma can also affect the arms and back.

While melasma isn't painful and doesn't present any health risks, it can cause significant emotional distress for the estimated six million American women who develop these dark patches on their faces.

What Causes Melasma?

Melasma has a lot of different causes but the two predominant ones are:

  • Hormones: Fluctuations in certain hormones can cause melasma, which is why it commonly occurs during pregnancy.
  • Sun Exposure: The sun is the big culprit in triggering melasma. Melasma can be caused or worsened by not only the sun's rays, but also heat and visible light. This means that even sunscreens that protect against skin cancer aren't enough to ward off melasma
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Can Melasma Be Treated?

Melasma can be very slow to respond to treatment, especially if it has been present for a long time. Treatment may result in irritant contact dermatitis in patients with sensitive skin, and this can result in post-inflammatory pigmentation. Dr. Alissa Lamoureux typically utilizes combination therapy partnered with the patient.

Melasma can fade on its own. This usually happens when a trigger, such as a pregnancy or birth control pills, causes the melasma. When a woman delivers her baby or stops taking the birth control pills, melasma can fade.

Melasma Treatments

Some people have melasma for years or even a lifetime. If the melasma does not go away or a woman wants to keep taking birth control pills, melasma treatments are available. These include:


This medicine is a common first treatment for melasma. It is applied to the skin and works by lightening the skin. You will find hydroquinone in medicine that comes as a cream, lotion, gel, or liquid. You can get some of these without a prescription. These products contain less hydroquinone than a product that your dermatologist can prescribe.

Tretinoin and Corticosteroids

To enhance skin lightening, your dermatologist may prescribe a second medicine. This medicine may be tretinoin or a corticosteroid. Sometimes a medicine contains three medicines (hydroquinone, tretinoin, and a corticosteroid) in one cream. This is often called a triple cream.

Other Topical (Applied to the Skin) Medicines

Your dermatologist may prescribe azelaic acid or kojic acid to help lighten melasma.


If medicine you apply to your skin does not get rid of your melasma, a procedure may succeed. Procedures for melasma include a chemical peel, microdermabrasion, dermabrasion, laser treatment, or a light-based procedure.

Do You Offer Technology (Laser) to Help Combat This Condition?

Light and laser-based treatments have been used for year to combat Melasma, but they were far from perfect. Most lasers deliver energy that creates too much heat in the skin which can exacerbate your Melasma or cause other pigmentation issues.

Skin Dermatology is excited to offer a new treatment utilizing our next-generation Lumenis PiQo4 picosecond and nanosecond laser. The PiQo4 delivers energy so quickly that the skin does not heat up. This is made possible by transferring light energy to brown spots in very short picoseconds, faster than nano- and milli- seconds.

The pigment absorbs it so quickly, that the energy is immediately converted into pressure, not heat. This pressure shatters the pigment particles into sand, which your body eliminates. The end result? Clearer skin without paradoxical darkening.

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Is This A One-Time Treatment?

Please understand that this is not a one-time treatment and not a cure for Melasma, as there is no cure yet. This is part of a treatment plan to help safely clear brown patches in which 6-8 weekly treatments are required. We work with you to determine the best treatment plan in addition to our state-of-the-art PiQo4.

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