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โปรโตคอลรักษาฝ้า — VERZO CLINIC กรุงเทพฯ

TL;DR: Melasma is a chronic pigmentation disorder driven by hormones (estrogen, progesterone), UV exposure, heat, and genetic predisposition. It affects the deeper dermal layer of skin, making it resistant to superficial treatments. Unlike sun spots, melasma can recur after treatment and requires ongoing management rather than a one-time solution.

Written by Dr. Waleerat Thaweebanchongsin, licensed physician with over 10 years of aesthetic-medicine experience in pigmentation management. VERZO CLINIC near BTS Ekkamai, Sukhumvit Road. Free consultations via LINE @verzo.

Last updated: April 2026

Frequently Asked Questions

What is melasma and why is it so difficult to treat?

Melasma is a chronic pigmentation disorder driven by hormones (estrogen, progesterone), UV exposure, heat, and genetic predisposition. It affects the deeper dermal layer of skin, making it resistant to superficial treatments. Unlike sun spots, melasma can recur after treatment and requires ongoing management rather than a one-time solution.

How does the Pico Laser + Tranexamic Acid protocol work?

The approach targets melasma from two angles. Pico laser with 1064nm MLA breaks up existing pigment deposits with minimal inflammation. Oral tranexamic acid reduces melanin synthesis systemically. Combined with daily SPF50+ and a topical prescribed at consultation, this works faster and holds longer than laser alone.

Does melasma ever go away for good?

Melasma is a chronic condition: it is managed, not cured. With the right protocol most patients see a substantial, visible reduction, and results vary between individuals. Maintenance treatments every 2-3 months and strict sun protection are essential to prevent recurrence.

Is tranexamic acid safe for melasma treatment?

Oral tranexamic acid at 250-500mg twice daily has been extensively studied for melasma with a good safety profile. It is not recommended for patients with history of blood clots, stroke, or those taking hormonal contraceptives. Dr. Waleerat screens patients before prescribing.

How long does melasma treatment take to show results?

Initial improvement is typically visible within 4-6 weeks. Significant improvement occurs over 3-6 months of consistent treatment. The combination protocol accelerates results compared to topical treatment alone. Monthly progress photos help track improvement.

What lifestyle changes help with melasma?

Strict SPF50+ sunscreen reapplied every 2-3 hours, wearing a hat and sunglasses outdoors, avoiding heat exposure (hot yoga, saunas), managing stress, and reviewing hormonal medications with your doctor. Sunscreen is the single most important factor in melasma management.

How much does the melasma treatment protocol cost?

The combination protocol typically costs 5,000-15,000 THB per session depending on components used. A typical 6-session program ranges from 30,000-90,000 THB. This covers the pico laser sessions and the tranexamic acid course. The exact protocol is set at consultation, since melasma depth and triggers differ between patients.

Can I use the protocol if I have dark skin?

Yes. The protocol suits all skin types including Fitzpatrick IV-VI. The pico laser at 1064nm with low fluence minimizes the risk of post-inflammatory hyperpigmentation, which is the main concern when treating pigmentation in darker skin, and tranexamic acid works systemically rather than on the skin surface.

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Pigmentation