Why your pigmentation came back

Someone finishes a course, the skin looks even, and four months later the patches are back. Almost always, the treatment worked. Something else undid it.

Pigment cells are not removed, they are quietened

Laser and peels break down pigment that has already been made. They do not remove the cells that make it. Those cells are still there, still responsive, and still waiting for a trigger.

The three triggers

Ultraviolet light. The obvious one, and the one people underestimate in a tropical climate. Incidental exposure — the walk to the car, the drive, the window seat — adds up to more annual UV than a beach holiday does.

Hormones. Melasma in particular is driven by oestrogen and progesterone. Pregnancy, the combined pill and some hormonal treatments will drive it back regardless of how good the laser was. This is why we ask.

Heat. Less well known and genuinely underrated. Cooking over a stove, hot yoga, a steam room — infrared and simple heat can provoke melasma without any UV at all.

What actually holds a result

SPF 50, broad spectrum, every morning, reapplied if you are outdoors. That is the whole intervention, and it is the one people skip. Tinted formulations containing iron oxide do noticeably better against melasma because they block visible light as well as UV.

Then maintenance: a topical that keeps the cells quiet between courses, and a single session at the interval your clinician sets rather than waiting for the patches to come back first.

What we will tell you at consultation

Melasma is managed, not cured. Our non-invasive melasma program is built around that honesty. If your pigmentation is hormonally driven, we will say so before you spend money, and we will set the expectation as control rather than clearance. Anyone promising otherwise is selling you something.