Skin Concerns
Pigmentation & Melasma Treatment in Brickell, Miami
"Pigmentation" covers three different problems that look similar: sun spots from UV, melasma driven by hormones and heat, and dark marks left behind by acne or irritation. Each responds to different tools, and choosing the wrong one, especially a high-heat device on melasma, can make things worse. In Miami's year-round sun, our plans combine low-heat technology, prescription brighteners and a strict sun and heat strategy.
- Session time: Varies by treatment
- Downtime: None to 3–7 days, by treatment
- Sessions typically needed: Sun spots 1–3; melasma or PIH 4–6
$50 deposit, applied to your treatment
- ★ Google 4.9 (218)
- Licensed medical providers
- Medical director oversight
- Consultation before every treatment
The Concern
Understanding pigmentation
Sun damage (solar lentigines, freckling, mottled tone). UV exposure stimulates melanocytes and, over years, leaves discrete brown spots and blotchy tone on the face, chest, shoulders and hands. These respond well to light and laser because the pigment is relatively superficial and well defined.
Melasma. Symmetrical tan-to-brown patches on the cheeks, upper lip, forehead or jawline. Triggers include UV, visible light, heat, hormones (pregnancy, contraceptives), genetics and some medications. It is chronic and relapsing, and it is prone to rebound after aggressive treatment.
Why melasma needs care with heat. Heat appears to stimulate the enzymes involved in melanin production and triggers low-grade inflammation and vasodilation, which can deepen patches. That is why high-energy IPL, aggressive CO2 and strong peels are usually avoided for melasma, and why Miami's climate (hot cars, beach, outdoor workouts, even cooking heat) is part of the conversation. Our melasma protocols favor low-fluence Pico, conservative 1927-type settings, gentle peels and prescription topicals, with "consistency over intensity."
Post-inflammatory hyperpigmentation (PIH). Brown, gray or purplish marks after acne, eczema, ingrown hairs, burns or procedures. More common and longer-lasting in medium to deep skin tones. Treating the underlying inflammation (e.g., active acne) comes first; brighteners and low-heat devices follow. Pink or red marks after acne are post-inflammatory erythema, which is vascular and responds to IPL/Laser Genesis instead.
Why the diagnosis matters. A Wood's lamp or close exam helps distinguish epidermal from deeper pigment, and melasma from sun spots. Deeper (dermal) pigment improves more slowly and partially.
Treatment Options
How we treat it
1. Pico laser — for sun spots, melasma (conservative) and PIH
- What it does for this concern
- Picosecond pulses shatter pigment with a photoacoustic effect rather than heat, which is designed to reduce the thermal injury that can trigger rebound or new PIH. Used in spot mode for lentigines and in low-fluence "toning" mode for melasma and diffuse tone.
- Sessions
- Sun spots 1–3; melasma/PIH 4–6 at 3–4 week intervals, then maintenance.
- Downtime
- Minimal; mild redness for a few hours; spots may darken and flake for 5–7 days.
- Who it suits
- A wide range of skin tones including medium and deeper tones, with manufacturer-stated ranges respected and test spots for melasma. Manufacturer-cleared indications include benign pigmented lesions and melasma (device-specific).
2. SpectraionX dual-wavelength laser (1927/1550-type non-ablative fractional) — for diffuse sun damage, tone and texture
- What it does for this concern
- The shallower 1927-type wavelength targets superficial pigment and photodamage across the whole face, chest or hands; the deeper 1550-type wavelength works on texture and fine lines. Non-ablative, so the surface stays intact. Melasma is treated only with conservative density/energy after provider assessment.
- Sessions
- 2–4, spaced 4 weeks apart.
- Downtime
- 3–7 days of redness, mild swelling and a "bronzed," sandpaper feel as pigment lifts.
- Who it suits
- Patients with widespread sun damage, "crepey" tone and spots across large areas; deeper tones with lower density settings.
3. IPL Lumecca — for sun spots and freckling (not for melasma-prone skin)
- What it does for this concern
- Pulsed light absorbed by melanin breaks up discrete spots, which darken then flake away; also treats redness at the same time, making it efficient for mixed red-and-brown sun damage.
- Sessions
- 1–3, about 4 weeks apart.
- Downtime
- Spots darken for 1–2 days then flake over 1–2 weeks; redness for hours.
- Who it suits
- Lighter to medium, untanned skin with sun spots; chest, hands and arms as well as face. Avoided for melasma, recent tan or deeper tones.
4. CoolPeel and full CO2 resurfacing (DEKA Tetra) — for sun damage with texture and fine lines
- What it does for this concern
- CoolPeel resurfaces the pigmented superficial layer with limited heat; full fractional CO2 goes deeper for heavy photodamage, lines and precancerous-appearing roughness (medical evaluation first). Used for sun damage, not melasma.
- Sessions
- CoolPeel 1–3 at 4–6 weeks; full CO2 usually 1.
- Downtime
- CoolPeel 2–5 days; full CO2 5–10 days of peeling and redness, pinkness for weeks.
- Who it suits
- Lighter to medium tones with textured sun damage; deeper tones only with provider judgment and pre-treatment, because CO2 carries PIH risk.
5. Chemical peels — for diffuse tone, PIH and melasma support
- What it does for this concern
- Superficial peels (mandelic, lactic, salicylic, modified Jessner's, low-strength TCA blends, brightening peels) accelerate turnover and carry brighteners into the skin; medium-depth options are reserved for sun damage in lighter tones.
- Sessions
- Series of 3–6, every 2–4 weeks.
- Downtime
- 0–3 days light flaking (superficial); 5–7 days peeling (medium).
- Who it suits
- PIH and melasma patients already on a prescription routine; deeper skin tones with superficial, buffered formulas.
6. HydraFacial and medical facials — for maintenance and product delivery
- What it does for this concern
- Gentle exfoliation plus infusion of brightening serums (e.g., vitamin C, tranexamic acid, niacinamide-containing boosters) designed to support tone between laser and peel sessions.
- Sessions
- Monthly.
- Downtime
- None.
- Who it suits
- Nearly everyone, including melasma patients between active treatments.
7. Prescription topicals — the foundation for melasma and PIH
- What it does for this concern
- When appropriate, prescribed by a licensed provider after consultation. May include hydroquinone (short, supervised courses), tretinoin, azelaic acid and compounded combinations; oral or topical tranexamic acid may be discussed where appropriate. Designed to slow pigment production so in-office treatments hold.
- Sessions
- Timeline: 8–12 weeks for visible change; cycled to avoid side effects.
- Downtime
- None; some dryness or irritation is managed with adjustments.
Sun protection is a treatment. Tinted, iron-oxide mineral SPF 30+ (which helps block visible light), reapplied every two hours outdoors, plus hats and shade. Without it, pigment treatments relapse.
Your Visit
What to expect
- Consultation: exam (often with a Wood's lamp), photos, history of melasma, pregnancy, hormones, medications, recent sun, prior reactions to procedures.
- Preparation: 2–4 weeks of prescription/brightening pre-treatment for melasma or deeper tones; no tanning for 4 weeks; stop retinoids 3–5 days before peels/lasers as instructed.
- During: Pico feels like quick snaps; SpectraionX feels like prickly heat with cooling; peels tingle.
- After: Pigment often looks darker before it flakes; this is expected.
Aftercare
Aftercare basics
Gentle cleanser, bland moisturizer, strict SPF; no picking at flaking; avoid heat exposure (sauna, hot yoga, direct midday sun) for 1–2 weeks; resume prescription brighteners when the provider says; schedule sessions when travel or beach plans allow sun avoidance.
Results
Results timeline
- Sun spots: many patients see lightening within 2–4 weeks of a session.
- Melasma: gradual, over 3–6 months with combined care; maintenance is expected; relapse is possible with sun or hormonal change.
- PIH: typically 2–6 months depending on depth and skin tone.
Questions
Frequently asked questions
Pricing: Pricing confirmed at consultation
Melasma is usually symmetrical, patchy and tied to hormones or heat; sun spots are discrete and scattered on sun-exposed areas. A provider exam, sometimes with a Wood's lamp, distinguishes them and changes the plan.
IPL's broad light and heat can stimulate melasma and cause rebound darkening. We reserve IPL for sun spots in untanned, lighter to medium skin and use low-heat options for melasma.
No single treatment does. It may lighten melasma meaningfully when combined with prescription topicals and sun/heat control, but melasma is chronic and maintenance is expected.
Often yes, with the right device and conservative settings (Pico, low-density SpectraionX, gentle peels) and pre-treatment to reduce PIH risk. IPL and aggressive CO2 are generally avoided.
Sun spots 1–3; melasma or PIH usually 4–6 plus a home routine. Individual results vary.
Sun exposure creates new pigment, and melasma can recur with heat, sun or hormones. Daily tinted SPF and maintenance sessions are designed to keep results.
Yes. IPL, Pico and SpectraionX are used off the face with adjusted settings.
When appropriate, it is prescribed by a licensed provider after consultation for a defined course and then cycled off, with monitoring. It is not sold over the counter in prescription strengths.
Most laser and prescription brighteners are postponed; we can discuss safe skincare and sun strategies in the meantime.
Direct midday sun, beach days without a hat and reapplication, hot yoga and saunas for 1–2 weeks, and tanning of any kind.
Keep Exploring
Related pages
- Skin rejuvenation guide
- Laser Skin Resurfacing
- IPL
- Cool Peel
- Deka CO2
- Chemical Peels
- HydraFacial
- Facials
- Acne
- Dull, dehydrated skin
- Skin Concerns
- Rosacea
- Acne
- Acne Scars & Texture
- Stretch Marks
- Fine Lines & Wrinkles
- Loose Skin
- Enlarged Pores & Oily Skin
- Dark Circles Under the Eyes
- Double Chin
- Dull & Dehydrated Skin
- All Skin Concerns
- Monday – Friday
- 10:00 AM – 6:00 PM
- Saturday
- By appointment only
- Sunday
- Closed