Melasma is one of the hardest skin issues to treat. The reason is that there is a multifactoral cause for melasma ranging from estrogen, environmental pollutants, UV exposure and even visible light exposure. Sunscreen is imperative to wear. The most important aspect of melasma when trying to treat with lasers is to not induce post inflammatory hyperpigmentation. Probably the best treatment to date is Picosure Focus lens and it typically takes around 5 treatments.