Can Thermage make melasma worse?

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I am a 43-year-old female with melasma. I have minimal sagging (cheeks, jowls) for which I am considering Thermage. Will the heat generated by the Thermage procedure aggravate my melasma? My melasma is under control with daily application of a hydroquinone mixture which also includes Vitamin A, Vit C and kojic acid prescribed by my dermatologist. I have read that lasers can worsen melasma so I want to be well-informed before I decide on the procedure. Thank you!

I never say never because we are all individuals but ……. in over 10 years of working with Thermage and several thousand treatments, we’ve not had a patient who’s melasma became  worse.  Also, I’ve never seen this reported in the medical literature.  Thermage is a radiofrequency technology (sound waves) not a laser (light waves).  Many lasers can and often do worsen melasma so you’re wise to be careful.    You didn’t mention that you are double sunscreening but I’m going to assume that you are.    Dr. I