Melasma treatment in Metro Manila

What melasma is

Patches of brown or grey brown pigment, usually symmetrical, usually on the cheeks, forehead, upper lip and jaw. It is driven by pigment cells that are overactive rather than by damage on the surface, which is why scrubbing at it does nothing and why it comes back.

Three things keep it going: ultraviolet light, visible light including the light from a phone screen and a bright window, and hormones, which is why it appears in pregnancy and with contraceptives. Heat matters too, which is a real problem in a tropical city.

That combination is why melasma is treated as a chronic condition to be managed rather than a mark to be removed. Any clinic that offers to clear it in one session is selling a rebound.

What the evidence supports

Sun protection first, and not as an afterthought. Broad spectrum with high protection, applied daily and reapplied, and a tinted product where the tint carries iron oxide, because visible light drives melasma and a clear sunscreen does not block it.

Topical treatment second. Hydroquinone, on its own or in a triple combination with a retinoid and a mild steroid, is the most studied prescription route. Azelaic acid and tretinoin are used where hydroquinone is not suitable. These are prescriptions, not shop purchases, and they are used in courses with breaks.

Oral tranexamic acid is prescribed in some cases and has a growing evidence base, listed in the sources below. It is a prescription medicine whose own labelling warns against use where there is a history of clotting, so it belongs to a doctor who has taken a history rather than to a clinic menu. The label is linked in the sources.

Procedures come last, as adjuncts. Low fluence pico or Q switched toning and light chemical peels can help when they sit on top of the topical routine. Run aggressively, the same devices make melasma worse, and the paper on 730 nm picosecond treatment in the sources is worth reading for how carefully the settings are described.

What makes it worse

Aggressive laser. The heat that clears a sun spot can inflame a melasma patch and leave it darker than before, and in deeper skin tones that outcome is common enough that it belongs in the conversation before payment.

Heat on its own, without light: steam, saunas, hot yoga, a hot kitchen. Waxing the upper lip and aggressive scrubs do the same thing through inflammation.

Stopping and starting. Melasma returns during an untreated summer, and a course abandoned after two months usually leaves the person believing the treatment failed.

What clinics here publish, and what they do not

Fifty three clinics that rank for these treatments in Metro Manila were checked on 18 September 2026. Eleven publish a price for something. Three publish a figure that can be tied to pigment work, and those are in the table below.

What almost nobody publishes is the part that matters most: the cost of a consultation, the cost of the prescription regimen, and the cost of the whole course rather than one session. A single session price for a condition that needs months of management is the least useful number in this market, and it is the number most often advertised.

Which patches this applies to

• Symmetrical brown patches on cheeks, forehead, upper lip and jaw
• Pigment that darkens in summer and after sun exposure
• Pigment that appeared during pregnancy or after starting contraceptives
• Mixed cases where melasma sits alongside sun damage

What it will not do:

• Freckles and single sun spots, which are simpler and respond to laser that melasma does not tolerate
• Post inflammatory marks left by acne, which fade on their own timeline with protection
• Grey pigment from long term hydroquinone misuse, which needs a doctor rather than another laser
• Any promise of permanent clearance. Melasma relapses, and a plan that does not include maintenance is not a plan

Who it suits

Anyone whose pigment is symmetrical, sits on the cheeks or upper lip, and darkens with sun. That pattern is the clue that sets melasma apart from sun damage.

Treatment suits people who will use sun protection daily. Without that, the rest is spending money to stand still.

It does not suit anyone looking for a single session fix, and prescription routes are not for anyone pregnant or breastfeeding without a doctor's involvement.

Published prices

These figures are not like for like. A price changes with the device or product, the area treated, the amount delivered and who delivers it, and not every clinic publishes those details. Read each row with its own line, and check the figure at the source before you use it.

As of 18 Sep 2026, Aesthetic Science Clinic publishes ₱7,000 for starting price, area not stated with PicoLO laser in Makati, Alabang, Quezon City, on its own site at aestheticscienceclinic.com.

Every clinic checked for this page

The count above is only worth something if it can be checked, so here is the whole list, including the clinics that publish nothing. Each site was read through its own XML sitemap on 18 September 2026, not only its home page. How that was done is set out in the method.

The other 50 clinics checked publish no price for this treatment anywhere on their own websites: Advanced Aesthetics, Avignon Clinic, Bangs Prime Skin, Beauty Clinic Manila, Bella Pelle, BGC Skin Clinic, Bioessence, Centuria Medical, CorDerm, Derma 360, Dermcare, Dr Lay T, DSC Beauty, Facial Care Centre, HAT Clinic, Hydra PH, Idara, K Skin, Kamiseta Skin Clinic, Luminisce, ME Clinic, Medico Global, Meraki Esthetique, Montesa Medical Group, New Angel Med, Nuvera Aesthetics, One Nadela Med, Rejuran BGC, Remedy, Renew Plus, Reverie Esthetic & Hair Center, RHMD, Sage Dermatology, Serenase, Shinagawa, Simply Skin, Skin Beauty Castle, Skin Republic, Skin Trends, SkinStation, SOI Clinic, Spectrumed, TBL Manila, The Aivee Clinic, The Blanche Beauty, The J Clinic, The Skin House, Three Wishes Clinic, UnderSkin, Wunderskin.

Before, during and after

Downtime. Little from toning or a light peel: some redness for a few hours. The risk here is not downtime, it is rebound weeks later if the settings were too strong.

When results show. Topical routines are judged at eight to twelve weeks, not two. Procedures added on top usually run as a short series with weeks between. Maintenance continues after that.

Before you pay, check these

Most of what goes wrong here is not a bad treatment. It is a price that covered less than the buyer thought, for a product or device nobody identified, delivered by someone nobody asked about. Each line below is a question with a checkable answer.

1. Is this melasma, and how do you know?Ask what in the pattern says melasma rather than sun damage or post acne marking. A clinic that cannot answer is about to treat the wrong thing.
2. What is the plan, not the session?Ask for the whole plan in writing: protection, topicals, any procedures, and how long before it is judged. If the answer is a package of sessions and nothing else, it is not a plan.
3. Which device and which settings?Ask for the device, the wavelength and whether the setting is low fluence toning. Melasma is one of the few conditions where a gentler setting is the correct one.
4. Will there be a patch test?For deeper skin tones ask for a test area and a wait. This is the single cheapest protection against a result that is darker than the start.
5. What happens if it rebounds?Ask what the clinic does if the pigment comes back darker: who you call, what it costs, and whether further sessions are charged.
6. Who prescribes?Hydroquinone and oral tranexamic acid are prescriptions. Ask whether a doctor is involved and takes a history, including clotting risk, before anything oral is started.
7. What does the course cost in total?Ask for the cost of the consultation, the products and the whole course. One session price for a chronic condition tells you almost nothing.

Signs to walk away from

• A promise to clear melasma permanently, or in one session.
• A laser recommended before anyone has discussed sun protection or topicals.
• A strong setting offered because a gentle one seems slow, in skin that darkens easily.
• A package of six sessions sold before an assessment.
• A product sold in clinic with no named active ingredient.
• Silence about pregnancy, contraceptives or clotting risk before an oral prescription.

Questions people ask

Sources

The clinical statements on this page follow the sources below. Prices are separate: each one links to the clinic page it was read from.

• American Academy of Dermatology on melasma treatment
• Tranexamic acid for hyperpigmentation disorders, literature review, 2026
• Oral tranexamic acid in melasma, 2025
• Tranexamic acid, patient information and cautions, NHS
• Low fluence 730 nm picosecond laser for melasma, 2025
• FDA Philippines verification portal, where a product registration number can be checked

What this page is, and how it was made

It was compiled by reading clinic websites, not by asking clinics for quotes and not by estimating. Every price links to the page it came from and carries the date it was read. Clinic pages change, so treat the date as the shelf life of the figure.

The clinical parts follow the published sources listed above. No doctor has reviewed this page, and it is not medical advice. It cannot tell you whether a treatment suits you, and it is not a substitute for an assessment by a clinician who can examine your skin.

Checked 18 Sep 2026.

Changes to this page

• 18 Sep 2026 First published. Three published figures from fifty three clinics checked.

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