How I Got Rid Of My Stubborn Melasma (And Am Keeping It Away!)

After struggling with melasma for over two decades, beauty journalist Lucia Ferrari has finally found a treatment that works for treating this particularly stubborn type of hyperpigmentation. Here, Lucia shares her tried-and-tested review of the clever laser combination she tried at Dr Maryam Zamani’s London clinic. Plus, she shows off some very impressive before-and-afters, which will have anyone with their own tricky hyperpigmentation patches queuing up to try the tweak for yourself…

My experience with melasma

Having lived with melasma on my face for the best part of 20 years or so (since having children), I’d rather come to accept I’d have it forever.  As a beauty journalist, I know how challenging this type of pigmentation can be to shift, and I know that you cannot really get rid of it forever without a serious commitment to skincare and/ or in-clinic tweakments. I just hadn’t got round to doing anything about it. As fellow melasma sufferer, oculoplastic surgeon Dr Maryam Zamani used to tell me, “melasma is an ongoing pigmentary condition of the skin that waxes and wanes and needs to be managed to keep it at bay.”

“melasma is an ongoing pigmentary condition of the skin that waxes and wanes and needs to be managed to keep it at bay.”

My best friend and I shared melasma in very similar, typical symmetrical positions on our faces just below our cheekbones. Always fans of the ‘every cloud has a silver lining’, we’d often have a giggle that we didn’t really need to use any contouring makeup as our pigmentation did the trick of enhancing our cheekbones naturally! But I wasn’t so thrilled when my pigmentation marks started creeping towards my upper lip, making me panic it may eventually spread to create a moustache effect (another typical place for melasma to appear).

UV exposure (as well as stress, hormonal changes, HRT and heat) can all exacerbate melasma, so spending most summers in Italy (and being on HRT) it was not surprising that I noticed that the depth of colour of my melasma was progressively darkening each year. Last Autumn when looking at my summer holiday pics I thought I really must do something about it. I’d also become quite self-conscious in work meetings with fellow beauty editors, imagining that they must think me lazy about my skincare, which of course isn’t the case, as we’re constantly testing something or other… but I was a bit flummoxed about what to do. So I was thrilled when I was asked to trial a melasma treatment for The Tweakments Guide at Dr Maryam Zamani’s clinic as I was hopeful it would be effective knowing she is a melasma sufferer herself.

UV exposure (as well as stress, hormonal changes, HRT and heat) can all exacerbate melasma

How can you treat melasma in clinic?

Dr Zamani explained that “post-summer is the perfect time to treat melasma, or any time during the winter months when you’re less likely to be exposed to intense UV rays.” And she also warned that key skincare is essential to be used after treatment.

There are several different ways to treat melasma: including in-clinic peels or multiple sessions of microneedling with topical tranexamic acid. But for my level of melasma, I was advised to have a combination of Moxi and Halo laser which I could have on the same day. Dr Maryam obviously treats every case individually but believes the key to treating melasma is a multi-pronged approach using laser treatments alongside appropriate skincare. She has had great success in clinic with this combination of lasers, treating her patients and her own melasma, and told me that she usually does a top-up treatment every September after the summer holidays.

Dr Maryam treats every case individually but believes the key to treating melasma is a multi-pronged approach using laser treatments in combination with skincare.

What was my melasma treatment like?

When I visited Dr Maryam’s clinic off the Kings Road for my appointment, the excellent aesthetician, Jaimie Davidson explained the two laser treatments I was about to have (both of which are from the laser company Sciton). Moxi laser is a fractional, non-ablative laser treatment which gently removes pigment from skin with little downtime. It is appropriate for all skin types and can be used on its own for sun damage. Halo is a fractional hybrid laser which is a more intense treatment and is used to improve skin texture, tone and treat deeper hyperpigmentation. The Moxi would take just 5 to 10 minutes, while the Halo takes a bit longer with more passes over the skin.

My treatment began with a Visia skin analysis which is an interesting diagnostic tool not only for the practitioner to see the level of damage which needs to be treated, but is also useful for the patient to see the improvement afterwards. I then had numbing cream applied before the lasers.

The Moxi laser was a doddle, I barely felt a thing. The Halo laser was more “spicy” and I was very glad of the cooling tube of icy cold air that I could hold and direct over my face as it was being treated. The entire thing was over in about 20 minutes. Then Jaimie quickly whipped a cooling sheet mask out of the fridge to immediately place over my red, hot face once the treatment was over. It was much needed.

Is there much downtime?

I don’t think I was quite prepared for the intense facial heat that followed the treatment and lasted for about an hour afterwards. Never has freezing cold December air felt so welcoming. I decided to walk home as even the thought of getting on the bus was making my burning cheeks feel even more uncomfortable and I felt a bit dizzy and headache-ey. Thankfully, after about an hour the heat and headache subsided. Make sure you are going straight home following the procedure: you won’t want to go back to the office or off to meet friends.

The downtime for me was about seven days. My face was quite swollen for about four days (I was warned about this, and took an anti-histamine tablet daily which helped). I also took oral cold sore tablets as if you’re prone to cold sores, lasers can cause an outbreak. After the treatment, wherever you’ve had pigmentation marks, you will develop dark patches of skin called MENDS (microscopic epidermal necrotic debris) which are tiny specks of dead skin tissue. They are part of the healing process and are a sign that new skin is generating. They eventually wash off after day seven. I was also advised to use Avene Cicalfate soothing balm (which they give you at the clinic) and to be vigilant about using SPF 50 every morning as part of the recovery.

What were your results like?

When the dark patches of skin (of which there were many) eventually washed away, I was amazed at the result. My face had not looked so clear for 20 years. The pigmentation was vastly improved with only the faintest hint of it remaining. And the overall skin clarity looked lovely and smooth. In fact, 0riginally my skin clarity scored 31% on the Visia, which went up to 72% after treatment, so I was utterly over the moon with the results! They were better than I’d expected. Even my sceptical husband was impressed (he’d been a bit concerned during the downtime). It’s certainly the most effective tweakment I’ve tried and I would put it up there alongside my first ever toxin experience when my forehead lines seemingly disappeared as if by magic.

I was amazed at the result. My face had not looked so clear for 20 years.

This Moxi-and-Halo combo definitely isn’t a treatment to be taken lightly as there is uncomfortable downtime involved, particularly if, like me, you have quite a lot of pigmentation. But in my opinion, it’s worth it. It’s also important to note, that this isn’t a magic bullet as everyone’s melasma is different.

What is the follow-up skincare routine?

Dr Maryam’s clinic follows up your treatment with some prescription skincare to use once the skin is clear. It’s a combination of Tranexamic Acid (5%), Azelaic acid (10%) and Kojic acid (6%) which will work to block pigment pathways and prevent tyrosine from converting to melanin in the skin. An over-the-counter vitamin C will also help, which I’m applying daily as well as an SPF 50. I will be more vigilant about wearing a hat in the summer months (especially in Italy) as I know how easy it is for melasma to return, but it’s wonderful knowing that you don’t have to live with melasma if you choose. And despite the challenge of treating melasma that had been building up for 20 years, this treatment worked wonders for me.

Find out more about treatments for melasma, and what causes tricky-to-treat pigment conditions, on our dedicated pigmentation concerns page.

Thanks to Dr Maryam Zamani for treating Lucia for this article. 

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