Melasma and Pigment Clinic in Karachi
Melasma and pigmentation treated as a managed condition. The MaQX Clear four-step laser protocol, depigmentation peels, Sylfirm X and prescription care, planned for brown skin.
Is melasma treatment right for me?
- For melasma, sun spots, post-inflammatory pigmentation and uneven tone on the face and body.
- Twenty to thirty minutes per session, four to six sessions a month apart, with mild redness for a day.
- Pigment lightens progressively over the course and stays lighter with sun protection and maintenance.
Clearer, even-toned skin.
Melasma is the pigmentation problem that comes back. Hormones, sun and heat drive it, brown skin is prone to it, and treatments that are too aggressive make it worse. At Dr. Fehmida Arif’s clinic in Karachi, melasma and pigmentation are treated as a managed condition: diagnosis first, then a combination that lightens it and a routine that keeps it away.
Why melasma keeps coming back
Melasma is more than extra pigment. The pigment cells in affected skin are overactive, the small blood vessels beneath them are increased, and the skin barrier is often weaker than normal. Ultraviolet light, the visible light in ordinary daylight, heat and hormones, including those of pregnancy and the contraceptive pill, all switch it back on. Karachi’s sun and heat make it a year-round problem.
That is why one strong treatment rarely lasts, and why aggressive lasers and peels often leave melasma darker than before. Every plan at the clinic includes a tinted sunscreen that blocks visible light as well as UV, and home care that continues after the laser sessions end.
Why diagnosis comes first
Melasma sits at different depths in the skin. Epidermal melasma, in the upper layer, responds fastest. Dermal and mixed melasma need gentler, more patient treatment, and some brown patches that look like melasma turn out to be sun damage, post-inflammatory marks or a different condition altogether. A Wood’s lamp and dermoscopy at the first visit decide which tools are used.
The centrepiece is the MaQX Clear protocol on the Fotona StarWalker MaQX: a four-step laser procedure that fragments melanin with Q-switched Nd:YAG pulses, treats the vascular component with low-fluence FRAC3 pulses, refreshes the surface with FracTAT fractional treatment and clears visible vessels with the VERSA mode. Around it sit depigmentation peels, Sylfirm X for the vascular component, laser toning, tranexamic acid and prescription creams, and strict sun protection.
Sessions take twenty to thirty minutes, four to six sessions a month apart, with little downtime.
The tools for pigment.
MaQX Clear
Four steps on the StarWalker MaQX: melanin fragmentation, vascular FRAC3, FracTAT resurfacing and VERSA vessel clearance.
MaQX Clear → LaserLaser toning
Low-fluence Nd:YAG for overall brightening.
Laser toning → DeviceSylfirm X
RF microneedling with a pulsed mode for the vascular part of melasma.
Sylfirm X → PeelDepigmentation peels
Cosmelan and Dermamelan style protocols and mandelic peels.
Depigmentation peels → PrescriptionCreams and tranexamic acid
Home treatment that does most of the long-term work.
Creams and tranexamic acid → ProtectionSun protection plan
Tinted mineral SPF and habits that stop recurrence.
Sun protection plan →Good candidates
- Melasma on the cheeks, forehead or upper lip.
- Sun spots and freckling.
- Post-acne or post-injury dark marks.
- Any brown skin tone; the plan is built for it.
Not suitable for
- Pregnancy for laser and some creams; safe options remain.
- A fresh tan or recent sun exposure.
- Isotretinoin in the past six months for resurfacing steps.
- Expectations of a cure; melasma is controlled, not erased.
Diagnose, lighten, maintain.
Diagnosis
Wood's lamp and dermoscopy show whether the pigment is epidermal, dermal or mixed, and how much is vascular.
Combination treatment
MaQX Clear laser sessions with peels or Sylfirm X as needed, and prescription home care from day one.
Maintenance
Sun protection, maintenance creams and a session every few months keep it away.
Before and after, by area.
Cheek
Melasma across the cheek lightened with the MaQX Clear protocol. Courtesy of Dr. Julio Cesar Vélez and Dr. Sebastián Vélez.
Clinical photography from Fotona, the maker of the StarWalker MaQX and SP Dynamis lasers used at the clinic, with the treating clinician credited on each set. Individual results vary.
From consultation to results.
Diagnosis, photographs and home care started.
Twenty to thirty minutes; pink for a day.
Pigment noticeably lighter.
Maintenance plan agreed.
"Melasma cannot be blasted away. It is managed, with the right laser at the right fluence, the right peel, and a patient who wears sunscreen. Done that way, it stays away."
Consultant Dermatologist and Laser Specialist. Over 35 years of dermatology, trained in Zurich, practising in Clifton since 1999. Page medically reviewed September 2026.
Melasma treatment, answered.
Straight answers from the clinic. If your question is not here, ask on WhatsApp.
Ask on WhatsAppOveractive pigment cells, triggered by sunlight, visible light, heat and hormones on a background of genetics. It is far more common in women and in brown skin, and often starts in pregnancy or on the contraceptive pill.
Yes. The StarWalker's Q-switched pulses and low-fluence modes are designed for pigmented skin, and the clinic's settings are conservative.
Twenty to thirty minutes.
Mild redness for a day; peels add a few days of flaking.
Lighter pigment after two to three sessions; the full result after the course.
It can, with sun and hormones. Maintenance and sun protection keep it controlled.
No treatment removes the tendency to melasma. It can be lightened a great deal and kept under control, which for most patients means clear skin with sunscreen, home care and occasional maintenance sessions.
It is one of the best-supported melasma treatments, used as a cream, in clinic treatments or as tablets. Tablets are prescribed only after a review of your medical history, because they are not suitable for anyone with a history of blood clots and some other conditions.
Laser and most prescription creams wait until after pregnancy and breastfeeding. Sun protection and a few pregnancy-safe products keep it from worsening in the meantime, and melasma that starts in pregnancy often fades partly afterwards.
A broad-spectrum SPF 50 that is tinted. The iron oxides in tinted sunscreens block visible light, which darkens melasma in brown skin even when UV is blocked. Reapply through the day, especially outdoors.
Yes. Heat from cooking, saunas, hot yoga and the Karachi summer can darken melasma without any sun at all, which is why heat-heavy treatments are avoided and settings are kept conservative.
It depends on the combination. Ask on WhatsApp for current pricing.
Start with a consultation.
A twenty-minute consultation with Dr. Fehmida decides whether this is the right treatment for your face, or whether something gentler or stronger would serve you better. Message on WhatsApp or leave your number and the clinic calls you back.
D200, Block 5, Clifton, Karachi. Monday to Friday 9:00 to 6:00, Saturday 9:00 to 5:00.
Call or WhatsApp 0301 827 9630