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Melasma expert in Los Angeles



Skin discoloration can affect both men and women, but is far more prevalent in healthy adult women of childbearing age.  Melasma is a benign skin condition characterized by abnormal skin pigmentation along the central face and nose, cheekbones, and jawline.  There are many causes of melasma, including exogenous hormones through birth control pills or hormone replacement, pregnancy, sun exposure, chronic inflammation, and family history.  Melasma can be treated effectively with a combination protocol developed by Dr. Karamanoukian, including lasers, light or heavy chemical peels, IPL photofacials, and topical creams such as Melarase AM and Melarase PM.


Melasma can be an embarrassing form of skin discoloration that can affect the face and neck.  If you have melasma, there are many new options available to help you treat your condition without significant downtime or stress.  The office of Dr. Raffy Karamanoukian can help you solve your melasma problems with the most state-of-the-art lasers, light-based therapies, topical creams, and chemical peels.  



If you have melasma, the first step would be to schedule a consultation with Board Certified Plastic Surgeon Dr. Raffy Karamanoukian, at which time he will evaluate the degree of skin pigmentation and determine whether the discoloration is truly melasma.  Melasma can then be classified as either epidermal, dermal, indeterminate, or mixed melasma depending on how deep the pigmentation is within the skin. Dr. Karamanoukian will also document the distribution of melasma along the centrofacial, malar, or mandibular areas of the face.  Some patients may have combined areas of distribution, making the melasma more spread out on the face.  Melasma treatment will begin with a high resolution photographic skin documentation profile using polarized and UV light to document progress within the next few months after treatment.  


Dr. Karamanoukian is also pleased to incorporate the MelaPeel into his practice as an effective method of removing stubborn skin discoloration and post-inflammatory hyperpigmentation.  MelaPeel works extremely well in patients with acne prone skin, large pores, and normal to oily skin.  The proprietary formulation uses a multimodality approach to control sebum production, control melanosome activity with tyrosinase inhibition, and stimulate exfoliation of skin.  Call our office today and speak to our patient care coordinator regarding MelaPeel, Melarase creams, or Melasma treatments with Dr. Raffy Karamanoukian. 


  1. Can melasma be worsened by thyroid problems? Although many female patients have simultaneous thyroid problems and melasma, few women know that the two conditions may be related.  Thyroid disease, particularly hypothyroidism, may be associated with the development of skin discoloration and pigmentation.  The first two steps in management include a visit to your endocrinologist or internist, followed by melasma treatment such as topical creams and MelaPeel once monthly. 
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