What should you know about Nd:YAG for melasma?

Melasma causes irregular brown or grey-brown patches, often on the cheeks, forehead, upper lip, or jaw. The colour sits at varying depths and may be influenced by sunlight, visible light, hormones, heat, or irritation. Nd:YAG energy can target pigment in selected protocols, yet laser heat may also aggravate pigmentation in some people. A clinician first confirms that the patches fit melasma rather than another cause of dark patches or uneven tone.

Laser is usually considered alongside a broader plan, which may include daily light protection and topical treatment. Depending on your skin and previous response, options such as chemical peel, microneedling, skin brightening treatment, or laser toning may be discussed. Improvement does not prevent future pigment triggers.

Share pregnancy or fertility plans, hormonal medicines, recent tanning, a history of pigment changes, cold sores, and every product used on the face. Follow instructions about pausing exfoliants or retinoids and avoid scheduling treatment over sunburn, active dermatitis, or an infection. Afterward, cleanse gently, avoid picking or heat, and use the recommended broad-spectrum sunscreen and protective habits consistently. Take progress photographs in similar lighting so changes can be judged over time rather than by day-to-day colour shifts.

Contact the clinic if treated areas blister, crust, become increasingly painful, or develop a strong new dark or pale patch. Prompt review is also sensible when redness spreads or an eruption appears. Seek urgent help for facial swelling with breathing difficulty. Do not add another pigment treatment to a reaction without an examination, because extra irritation can make the colour change harder to control.

Ask how the diagnosis was made, whether your melasma is superficial or deeper, why Nd:YAG is being suggested, and what non-laser options fit your skin. Discuss the risk of a darker or lighter mark, the planned test spot or settings, sun and heat precautions, and how recurrence would be managed.