What is Melasma & Pigmentation?
Melasma is a common acquired pigmentary disorder characterised by symmetrical brown or grey-brown patches, most often appearing on the cheeks, forehead, upper lip, and chin. It is influenced by sun exposure, hormonal fluctuations, genetic predisposition, and heat — factors that are particularly relevant in Bali's tropical climate. Broader pigmentation concerns may include post-inflammatory hyperpigmentation (PIH), solar lentigines, and uneven skin tone arising from acne, injury, or cumulative UV damage. At Kirana Skin Clinic in Ubud, each patient undergoes a thorough skin assessment conducted by a certified Sp.DV dermatologist before any treatment is recommended. Management typically combines prescription topical agents (such as depigmenting formulations), procedural options including medical-grade chemical peels or laser therapy, and a structured sun-protection protocol. Because melasma is a chronic condition prone to recurrence, ongoing maintenance and consistent SPF use are central to sustained management. Individual responses vary; realistic goals and a personalised care plan are discussed in full at the initial consultation.
Source: DermNet: Melasma
Who it is suitable for
- Adults experiencing melasma or hormonally-driven facial pigmentation
- Those with post-inflammatory hyperpigmentation from acne or past skin trauma
- Individuals with sun-related dark spots or uneven skin tone
- People who have found over-the-counter lightening products insufficient
- Patients with darker Fitzpatrick skin types (III–VI) who require specialist assessment before laser or peel procedures
- Anyone wishing to understand the cause of their pigmentation before beginning treatment
How it works at Kirana
- 1
Initial consultation with the Sp.DV dermatologist: skin history, trigger identification, and Fitzpatrick skin-type assessment.
- 2
Personalised treatment plan: the doctor discusses suitable options — topical agents, chemical peel, laser, or a combination — along with realistic expectations and timelines.
- 3
Pre-treatment preparation: skin priming with prescribed topicals if indicated; strict sun avoidance and SPF use in the weeks prior to procedures.
- 4
In-clinic procedure: the chosen treatment (e.g. chemical peel or laser session) is performed by the dermatologist in a clinical setting with appropriate skin monitoring.
- 5
Post-procedure care: tailored aftercare instructions provided, including specific topical products, SPF requirements, and activities to avoid.
- 6
Follow-up and maintenance: scheduled review appointments to monitor response, adjust treatment if needed, and discuss long-term maintenance to reduce recurrence.
What to expect
Before
You will be asked to complete a skin and health history form before your consultation. If any procedural treatment is planned, the doctor may prescribe preparatory topicals to use for several weeks in advance.
During
Procedures are performed in a calm clinical environment. Depending on the treatment selected, you may experience mild tingling, warmth, or temporary stinging — sensations that are normal and monitored by the treating doctor throughout the session.
After
Some redness, mild sensitivity, or flaking is common in the days following a procedure and typically resolves within the expected recovery window. Consistent SPF use is essential from the day after treatment onward. Visible changes in pigmentation tend to develop gradually over several weeks, and individual outcomes vary.
Downtime and recovery
| Day 1–2 | Mild redness and skin sensitivity are common immediately after procedural treatments. Avoid direct sun exposure entirely; SPF 50+ is mandatory when outdoors. |
|---|---|
| Day 3–5 | Light flaking or peeling may occur, particularly following chemical peel sessions. Do not pick or rub the skin; allow natural shedding to take place. |
| Week 1–4 | Skin continues to renew. Pigmentation may appear temporarily darker before it lightens — a known process called 'purging' or post-peel darkening. Strict sun protection and prescribed topicals must continue throughout this period. |
| Ongoing maintenance | Melasma is a chronic condition. Long-term SPF use, periodic follow-up consultations, and maintenance treatments as recommended by the dermatologist are important to help sustain results and manage recurrence. |
