Melasma Treatment in Dallas
Melasma is the hormone- and sun-driven brown or gray patches on the cheeks, forehead, and upper lip. It is treatable but recurring — managed, not cured. At Sanjiva, a board-certified physician builds a cautious, prescription-led plan that improves melasma without the rebound darkening aggressive treatment can cause, especially in darker skin tones.

Melasma needs restraint, not aggression.
Melasma is driven by hormones, sun, heat, and visible light. The melanocytes are easily provoked — so heat-based lasers, harsh peels, or over-treatment can trigger rebound darkening, particularly in deeper skin tones. The most effective plans start with prescription topicals and strict sun protection, and use devices only cautiously and later.
Not sure it’s melasma? Discrete spots from sun or post-acne marks are different and often clear more easily — see our hyperpigmentation treatment in Dallas page. We’ll confirm with an exam and a complimentary Visia skin analysis.
Common melasma triggers
- Pregnancy and hormonal shifts (“the mask of pregnancy”)
- Birth control and hormone therapy
- Sun and heat exposure — including Dallas summers
- Visible light from screens and the sun
- Genetics and skin of color
A physician-led treatment ladder
We start gentle and add intensity only as your skin tolerates it. The prescription layer is the part a spa without a physician cannot offer.
Prescription & medical-grade topicals
Triluma — the only FDA-approved prescription for moderate-to-severe facial melasma (hydroquinone + tretinoin + a low-dose steroid), used in a short supervised course. We may also prescribe hydroquinone 6–8% and custom-compounded brightening formulas — all in supervised cycles.
Pigment-safe peels
VI Peel Precision Plus with Peptides and gentler BioRePeel options refine tone and drive brighteners deeper — chosen and timed to avoid provoking pigment.
Safer melasma care for deeper skin tones
Melasma is most common — and most stubborn — in South Asian, Hispanic, Black, Middle Eastern, and Mediterranean skin, which are also most prone to rebound pigment from aggressive treatment. Our prescription-first, heat-cautious approach is built to treat effectively without making pigment worse.
Our dark-skin laser expertiseRealistic expectations
Anyone promising to erase melasma permanently is overselling. The honest goal is meaningful, lasting improvement with a maintenance routine you can sustain — daily broad-spectrum mineral SPF, a brightening regimen, and periodic in-office treatment. Sun protection isn’t optional; UV and visible light undo pigment work faster than anything else.
Colorescience tinted mineral SPF protects against both UV and visible light.
The diagnosis is the treatment.
Melasma, sun damage, and post-acne marks can look alike but need different plans — and the wrong one can worsen pigment. Lasting results start with understanding the cause, then matching every step to your skin tone, sensitivity, hormones, and history.
Melasma is a chronic, recurring condition. Treatment is most successful when it is physician-guided, conservative, and paired with strict daily sun protection — because UV and visible light can darken existing pigment, trigger new patches, and drive recurrence after treatment.
Praveen Guntipalli, MD, FACP
Medical Director, Sanjiva Medical Spa
Melasma questions
Can melasma be cured?
No — melasma is chronic and can recur with sun, heat, and hormones. A good plan reduces the pigment and the frequency of flares, then keeps it controlled with maintenance and sun protection.
What is the best treatment for melasma?
For moderate-to-severe facial melasma, Triluma is the only FDA-approved prescription and is usually the foundation, often with hydroquinone, pigment-safe peels, and cautious laser. The right mix depends on your skin tone and triggers, confirmed at consultation.
Is laser safe for melasma, especially on darker skin?
Only with caution. Heat can trigger rebound darkening on deeper skin tones, so we pre-treat with hydroquinone and sun protection, use conservative settings, and reserve laser as an advanced step — never the first move.
Does Sanjiva provide prescription melasma treatment?
Yes. Because we’re physician-owned, Dr. Guntipalli can prescribe Triluma, hydroquinone 6–8%, and compounded brightening formulas — options a spa without a physician cannot offer.
Can I treat melasma while pregnant or breastfeeding?
Prescription retinoids and hydroquinone aren’t used during pregnancy or breastfeeding. We focus on sun protection and safe measures now and plan active treatment for afterward.
A clear melasma plan starts with the right diagnosis
Book a consultation with a complimentary Visia skin analysis. We’ll confirm whether it’s melasma, identify your triggers, and build a cautious, physician-led plan for your skin tone.
Sanjiva Medical Spa · 5633 W Lovers Lane, Dallas, TX 75209 · Results vary. Melasma can recur.