I still remember the first patient who came in tears about โdirty lookingโ patches on her cheeks. Sheโd stopped going out without makeup. If thatโs you, take a breath. Youโre not alone, and youโre not stuck with it.
As a physician and someone who has seen a lot of melasma up close, hereโs the most helpful way to think about it: melasma is a chronic, trigger-prone pigment condition. You can get it dramatically better (often to the point where itโs barely noticeable), but it requires smart, gentle care and consistency.
In this post, Iโll break down what melasma is, how to tell it apart from look-alikes, why lasers so often make it worse, and the treatments I recommend at Glow to safely restore clarity.
Melasma is a form of hyperpigmentation most often appearing on the cheeks, nose, forehead, upper lip, and jawline. It usually looks map-like (think outlineable โislandsโ) and it tends to be symmetrical. While itโs most common on the face, it can show up on the chest and arms too.
Why it happens is multi-factorial:
Patients often ask, โIs this a sunspot or melasma?โ
Why it matters: melasma behaves differently, and responds best to gentle, anti-inflammatory strategies.
Letโs address the elephant in the treatment room. Iโm often begged to โjust laser it off.โ I get it, lasers can quickly clear visible pigment. But with melasma, that win is frequently short-lived.
Hereโs the issue: many lasers and intense light devices deliver heat or explosive energy to break up pigment. Melasma is heat-sensitive and inflammation-prone. So while you might look clearer right after treatment, a rebound flare can appear weeks to months later, sometimes worse than where you started.
My rule of thumb: no lasers for melasma. The rare exception would be under a true laser specialist using ultra-gentle, ultra-short-pulse protocols after everything else has failed, and even then, with caution. Medicineโs first principle is โdo no harmโ; since we have safer, effective alternatives, we donโt have to gamble.
Melasma needs kindness, not aggression.ย Superficialย peels help by liftingย pigmentย sitting in the top layersย andย by reducing inflammation.ย
Key, melasma-friendly ingredients we use in tailored peel protocols:
What to expect: a series of 3โ6 light peels, often every 2โ4 weeks. Pigment can look a touch darker at first as it rises, then it lifts. After your series, weโll set a maintenance cadence (often 1โ2 touch-ups per year).
What I avoid: the old โtriple creamโ approach (hydroquinone + tretinoin + steroid) as a long-term plan. Chronic steroid use can thin skin and promote vascular changes; we can achieve excellent results without that trade-off.
In stubborn, recalcitrant melasma that hasnโt responded to the above, short courses of oral TXA can be effective. We reserve this for carefully screened patients because TXA may increase clotting risk in susceptible individuals.
We do not use oral TXA if you:
If appropriate, protocols are short and finite (often 8โ12 weeks) with close follow-up and always paired with a robust topical routine and trigger control.
If you notice pigment with hairline recession or patchy scalp changes, ask a dermatologist to evaluate for lichen planus pigmentosus (and related scarring alopecia). Thatโs a different condition and requires a different, often more anti-inflammatory approach.
Melasma is chronic, but highly manageable. Our goal at Glow is to calm the biology, lift the pigment safely, protect the barrier, and help you avoid flares. Most patients can get to โbarely noticeableโ with less makeup and more confidence.
Think of it as a partnership between you, your skin, your lifestyle, and your care team.
If youโve been battling stubborn discoloration, weโll build a personalized, physician-led plan that respects your skinโs biology and your lifestyle.
I just finished recording a conversation with Nicole Gregory for Medspa Mayhem, and I canโt stop thinking about how important this topic is. Nicole owns med spas in Michigan, has her MBA, and founded MI Spa, so sheโs not just talking theory, sheโs in the trenches every day. What struck me most during our conversation was just how confusing it is for consumers to tell the difference between a safe, legal med spa and one thatโs operating illegally.
From the outside, all med spas look the same. Theyโve got polished websites, beautiful Instagram feeds, and a menu of Botox, fillers, lasers, and IV drips. But behind the scenes, thereโs a world of difference. Some are doing everything by the book - licensed medical directors, proper exams, emergency protocols, malpractice insurance, the works. And then there are the others: spas with absentee or โfakeโ medical directors who sign off on dozens of clinics across multiple states, spas with no safety net if something goes wrong, spas owned illegally by people who arenโt even allowed to own a medical practice.
This is exactly why we created the Medspa Board. The idea is simple: a certification process that helps consumers know when a med spa is legitimate and gives ethical providers a way to stand out. Itโs not enough to just say โtrust us.โ Patients deserve proof that the people treating them are trained, supported, and operating within the law. Certification gives them that peace of mind, and it also gives businesses a way to show, clearly and publicly, that theyโre committed to doing things right.
Nicole and I also talked about how legislators are often surprised to learn thereโs no existing certification requirement for med spas. Even lawmakers walk into their own appointments assuming the doctorโs name on the website means everything is fine. But thatโs not how this works. Most patients donโt know to ask if the doctor is actually on site, if theyโve been involved in their care, or if the spa has malpractice coverage. And honestly, why would they? As a consumer, you shouldnโt have to be a detective just to get safe Botox.
What weโre trying to build with the Medspa Board is both transparency and accountability. If youโre running a med spa and doing things correctly, youโll be able to point to certification as proof. And if youโre a patient, youโll be able to go to a directory and say, โOkay, this place has been vetted. I know Iโm safe here.โ That kind of clarity doesnโt exist right now, and itโs badly needed.
The heart of this work, for me, comes back to something I said in the episode: ethics is doing the right thing when no oneโs looking. Regulation is what happens when too many people donโt. The med spa industry has exploded in recent years, and itโs full of good people, but itโs also full of people cutting corners. If we donโt take responsibility for raising the standard ourselves, regulation will eventually come, and it probably wonโt be done in a way that helps either consumers or ethical providers.
My hope is that certification becomes a no-brainer for everyone. If youโre a provider, why wouldnโt you want to show your patients that youโre legitimate? And if youโre a consumer, why wouldnโt you want the reassurance that the people treating you have been properly vetted? Itโs not about scaring people away from aesthetics. Itโs about giving them the tools to make smart, safe choices and making sure the businesses doing things right are recognized for it.
Want the full story? Listen to my conversation with Nicole Gregory on Medspa Mayhem to hear firsthand why certification matters and how it will change the industry.
DIY skincare is everywhere these days - soaps, scrubs, serums you can mix up at home. Iโll be honest: Iโve never made soap myself, and as a doctor, I tend to see the risks before the romance. Thatโs why I wanted to talk with Anne-Marie Faiola, founder of Bramble Berry. Sheโs spent decades teaching people how to make skincare safely, and sheโs seen firsthand what can go right, and what can go wrong.
The biggest one? Poor preservation. Any time you make a lotion, cream, or toner with water in it, you need a preservative. Without it,E mold and bacteria can grow, even if the product looks perfectly fine. Most of the time, nothing dramatic happens. But once in a while, it does, like when customers at Lush found little โtreesโ sprouting out of their shower drains thanks to unpreserved products. Funny to imagine, but not so funny if it ends up on your skin.
Preservatives such as parabens have gotten a bad reputation, but the truth is theyโre some of the most effective and well-studied options out there. Iโd rather see a lotion with parabens than one with a pretty โparaben-freeโ label that canโt actually keep bacteria out.
Another pitfall is bad or mislabeled ingredients. Beeswax looks a lot like emulsifying wax, but they donโt work the same way. Swap them by mistake and your lotion wonโt hold together. And if you buy from the wrong seller online, you might not even be getting what you think. Anne-Marie says some sellers pass off plain cornstarch as expensive hyaluronic acid powder. Unless youโre sourcing from reputable suppliers who provide proof of quality, you canโt always trust whatโs in the bag.
And then there are the too-good-to-be-true claims. A cream that promises to โrebuild collagen overnightโ is selling you hope, not science. Topicals just donโt work that way. Look for honest language like โsoftens skinโ or โhelps with hydrationโ - it shows the maker respects both science and their customers.
DIY skincare can be fun and rewarding, but only if you keep it simple and safe. If you want to experiment, start with soaps or scrubs - low-risk projects that let you be creative without courting disaster. Always use reputable suppliers and donโt skip preservatives in anything water-based. And if chemistry isnโt your thing, thatโs okay too. Supporting a small maker who does it right is often the best, and safest, choice for your skin.
Thinking about upgrading your skincare routine? Book a consultation at Glow Medispa and let us help you separate fact from fiction.
We are incredibly honored to be recognized three years in a row in The Seattle Timesโ Best in the PNW awards!
2025 โ Gold Winner: Best Medspa
2025 โ Bronze Winner: Best Facial
2025 โ Bronze Winner: Best Customer Service
2024 โ Gold Winner: Best Medspa, Silver Winner: Best Facial
2023 โ Winner: Best Medspa, Best Facial, Best Customer Service
These awards are particularly meaningful to us because they are decided entirely by the community. Your votes, loyalty, and trust have helped Glow Medispa grow and thrive, and we couldnโt be more grateful.
About the Best in the PNW Awards
Organized annually by The Seattle Times, the Best in the PNW contest celebrates top businesses across a wide range of industries through public nominations and voting.
Each summer, readers across the Pacific Northwest cast their votes over a two-week period. The winners are then announced both online and in print in the fall.
In 2023, Glow Medispa was honored in three categories, including Best Medspa, Best Facial, and Best Customer Service.
In 2024, we took home Gold for Best Medspa and Silver for Best Facial.
In 2025, we were thrilled to once again win Gold for Best Medspa (our third year in a row!) along with Bronze awards for both Best Facial and Best Customer Service.
We are proud to be recognized for our clinical excellence, patient care, and commitment to results.
What Sets Glow Medispa Apart
As a medical spa, our focus is on results-driven, research-backed aesthetic care, without ever losing sight of the personal attention each patient deserves.
We specialize in a wide range of treatments, including:
All services are delivered by highly trained medical professionals and master estheticians in a welcoming, supportive environment.
Thank You!
Winning in 2023, 2024, and now 2025 is something we donโt take for granted. It inspires us every day to continue elevating our standards, investing in education and innovation, and, most importantly, taking great care of our patients.
Whether youโre new to Glow or a long-time regular, thank you for being part of our journey.
Come See Why Weโve Been Voted the Best
We invite you to schedule a consultation and experience the care, quality, and results that earned us these honors.
Call, email, or book online. Weโd love to welcome you.ย
What if we could turn back the biological clock?
On this episode of Medspa Mayhem, Dr. Kate Dee sits down with board-certified plastic surgeon Dr. Richard Baxter to discuss regenerative medicine for aging, evidence-backed longevity treatments, and whatโs actually working to improve both how we lookโand how long we stay healthy.
โWhatโs most exciting is that there are things you can do, shown in prospective clinical trials, that reverse aging.โ โ Dr. Richard Baxter
What Is Regenerative Medicine for Anti-Aging?
Regenerative medicine focuses on restoring and rejuvenating tissue at a cellular level, going beyond superficial cosmetic treatments to actually target the root causes of aging. It includes a range of therapies designed to:
In aesthetics, this often looks like PRP, exosomes, nanofat injections, and new biologic solutions like PDGF (platelet-derived growth factor).
Cutting-Edge Aesthetic Tools: PRP, PDGF, and Beyond
Dr. Baxter shares how his practice has evolved beyond traditional facelifts to include regenerative tools like:
โWeโre not just reshaping tissueโweโre restoring it.โ
Biological Age vs. Chronological Age
One of the most powerful shifts in longevity medicine is the ability to measure biological age using epigenetic testing. These tests look at DNA methylation markers to determine how your body is aging on a cellular levelโand how interventions are working over time.
This gives patients and providers an objective way to track the impact of supplements, peptides, and lifestyle changes.
Therapies That May Reverse Aging
Therapeutic Plasma Exchange
A groundbreaking procedure that filters the plasma in your blood and replaces it with clean proteins. In clinical trials, this has reversed aging biomarkersโmaking it the first interventional treatment proven to do so in a randomized, controlled trial.
โRight now, plasma exchange is the only intervention shown in a clinical trial to reverse biological age.โ
Metformin
Originally a diabetes drug, metformin has shown longevity benefits in multiple studiesโincluding reduced cancer risk and longer lifespan even in diabetic patients.
Peptides
Peptides like growth hormone-releasing peptides aim to replicate the benefits of HGH without the side effects. When used correctly, they can promote better metabolism, energy, and recovery.
Everyday Longevity: Lifestyle + Supplements
Dr. Baxter emphasizes that while advanced treatments are exciting, the foundations of healthy aging start with daily habits:
How to Find Safe, Qualified Providers
As treatments like plasma exchange and biologic injections become more accessible, Dr. Dee and Dr. Baxter caution listeners to prioritize provider safety and training.
โYou canโt go to some random provider for this. You need someone highly trained and trustworthy.โ
Start Your Longevity Journey
Whether you're looking to improve your skin, increase energy, or extend your healthspan, regenerative medicine for aging is no longer science fictionโitโs here, and itโs evolving fast.
???? Listen to the full episode: Medspa Mayhem Podcastย
???? Download Dr. Baxterโs free longevity guide: drbaxter.com/resourcesย
???? Dr. Baxterโs Clinic: Mountlake Terrace, WAย ย
Ready to explore anti-aging and regenerative treatments?
Book a consultation to start your personalized longevity plan today.
โWhatโs the latest thing in aesthetics that I should be thinking about doing?โ That is the one question I get almost every day.
Those of you who know me will know Iโm very conservative (and skeptical!) when it comes to the latest hype in our industry. It has been quite a while since a new product or procedure has come along that got me this excited.
But PDGF is the bomb! Or at least I truly believe it is a game-changer. Hereโs why.
PDGF is Platelet-Derived Growth Factor. It is a protein made in your body that is a potent stimulant of healing, and when your skin cells respond to it, they make collagen and elastin โ the holy grail of anti-aging.
You may have heard about PRP (Platelet-rich Plasma) or PRFM (Platelet-rich Fibrin Matrix). Weโve used both for years to stimulate collagen and elastin, with great results for skin rejuvenation and under-eye treatments.
Hereโs the key: PDGF is the most important growth factor in PRP and PRFM โ itโs responsible for much of the visible results from these procedures. And now, thereโs a pure, sterile PDGF product thatโs FDA-approved for human use.
PDGF can be used topically or as an injectable, similar to PRP or PRFM. The FDA has approved the product for injecting into bones, joints and wound-healing. It has not been approved for aesthetic use, so using it for aesthetic injections, for instance for tear troughs or hair loss, is considered off-label. Just as any other product, using it topically does not require FDA approval. The product is packaged for topical use, but many people are using it for injections.
PDGF (ingredients: Water, Sodium Acetate, sh-Polypeptide-59 Dimer, aka PDGF-BB or rhPDGF-BB) is a growth factor used as an ingredient in four separate FDA-approved medical products for four different therapeutic uses:
GEM 21Sยฎ
Augmentยฎ Bone Graft
Augmentยฎ Injectable
Regranexยฎ Gel, for topical use
Because PDGF is sterile and ready to use, thereโs no blood draw and no prep time. What once took 45 minutes (like a tear trough treatment) could take less than 15.
Also, because PDGF is so much more potent, the potential benefits are that much better. While there are no randomized controlled trials yet โ as is typical in aesthetics โ the science is promising.
The cost of PDGF is comparable or only slightly more expensive than the cost of PRP or PRFM. This depends on the PRP system used, but overall pure recombinant PDGF is orders of magnitude stronger for the minimal additional investment.
I have no doubt weโll see even more uses for PDGF in the near future.
Curious to learn more? Call us Kirkland or West Seattle or schedule a consultation!
When it comes to preventing premature aging, not all sunscreens are created equal. The right formula can protect your skin from sun damage, reduce fine lines and dark spots, and keep your complexion looking healthy for years to come.
Hereโs what truly matters when youโre choosing a sunscreen for anti-aging:
Not all sunscreens work the same way. There are two main types โ mineral and chemical โ plus a โhybridโ option that blends the two.
How they work: They sit on top of the skin and reflect or scatter UV rays like a shield.
Active ingredients: Zinc oxide, titanium dioxide
Pros
Cons
How they work: They absorb UV rays and convert them into heat, which is then released from the skin.
Active ingredients: Avobenzone, oxybenzone, octinoxate, octocrylene
Pros
Cons
How they work: These combine mineral and chemical filters, offering the balance of immediate protection, cosmetic elegance, and skin tolerance.
Why choose them: Theyโre ideal for people who want the look and feel of a chemical sunscreen with the added benefits of mineral ingredients.
Now that you know what to look for, here are two patient favorites that check all the boxes for everyday, anti-aging protection:
Layering an antioxidant serum, like a vitamin C serum, underneath your sunscreen in the morning can significantly improve anti-aging protection and skin health.
Schedule a personalized consultation onlineย or call us at (425) 522-4477 (Kirkland) or (206) 228-7281 (West Seattle).
What do salmon sperm, John Oliver, and regenerative skincare have in common?
More than you'd think.
On a recent episode of Medspa Mayhem, Dr. Kate Dee sat down with Dr. Flora Waples, ER doctor turned medical aesthetics expert, to unpack the buzz around polydeoxyribonucleotidesโbetter known as PDRNs, and less elegantly known thanks to late-night TV as salmon jizz.
While the nickname is unfortunate, the science behind PDRNs is surprisingly compelling. Hereโs what you should know if youโre curious about DNA-based skin rejuvenation, whether itโs safe, and how to tell real treatments from gimmicks.
What Are PDRNs and Why Are They in Skincare?
PDRNs (polydeoxyribonucleotides) are small fragments of DNA used to stimulate skin regeneration. These molecules mimic the bodyโs natural response to injuryโwithout actually causing damageโby signaling to skin cells that itโs time to start repairing and rebuilding.
So why salmon sperm?
To get PDRNs, you need DNA. And to meet strict European safety and ethics regulations, manufacturers needed a non-lethal, non-invasive way to harvest it. Enter: farmed salmon. During spawning, they naturally release large volumes of sperm, which is rich in pure, clean DNA.
Salmon sperm is:
How PDRNs Trick the Skin into Healing
Traditionally, skin rejuvenation relies on controlled injuryโthink lasers, chemical peels, or microneedlingโto trigger the healing response that boosts collagen and elastin production.
But PDRNs offer another route.
When your skin cells are damaged, they release DNA fragments into the surrounding tissueโbasically a distress signal. Researchers discovered that applying those fragments externally (via injection or topically post-procedure) can simulate that same โhelp me healโ signal without causing real trauma.
The result? Accelerated healing, improved texture and tone, reduced pigmentation, and better outcomes with less downtime.
โYou're trying to trick the skin into thinking there's a woundโand DNA fragments are a very effective way to do that.โ
โ Dr. Flora Waples
Topical vs. Injectable PDRNs: What's the Difference?
PDRNs can be:
In Europe and Asia, injectable PDRNs are widely used. In the U.S., itโs legal to apply them topicallyโbut injections are considered off-label use and must be done by a physician.
Good to know: DNA from salmon is highly conserved and, when purified, carries no risk of allergic reaction or gene insertion.
Do They Work? The Results So Far
While robust clinical trials are lacking (as with many aesthetic treatments), practitioners like Dr. Waples have seen promising results:
Some international providers are even combining PDRNs with dermal fillers for added regenerative effectโthough this isn't yet approved in the U.S.
PDRNs vs. Exosomes: Whatโs the Difference?
Another trendy regenerative tool in aesthetics is the exosomeโa tiny โenvelopeโ that delivers growth factors to cells. While promising, exosomes are harder to control. The content inside can vary widely depending on the source (plant, platelet, placenta), and many are poorly regulated or lack transparency.
โExosomes are envelopes. Whatโs inside them matters. With PDRNs, I know what Iโm deliveringโand the body knows how to respond to it.โ
โ Dr. Flora Waples
Thatโs why some providers prefer PDRNs: theyโre simpler, purer, and better understood.
How to Know If Youโre Getting the Real Deal
With โsalmon sperm facialsโ popping up everywhere, how can you tell whatโs legit?
3 Questions to Ask Before Booking:
Pro tip: If they wonโt show you the vial or canโt name the manufacturer, walk away.
Why You Should (Still) Be Cautious
Even though PDRNs seem safe and effective, this is still the Wild West of regenerative aesthetics. Without large-scale clinical trials, much of the data comes from manufacturers themselves. Thatโs why providers like Dr. Dee and Dr. Waples take a cautious, science-first approach to adopting new technologies.
And why they definitely donโt want you getting treatments from someone who got their โsalmon spermโ out of a Gatorade bottle in the fridge. (Yes, seriously.)
Bottom Line: Science, Not Snake Oil
The name might make headlines, but PDRNs are more than hypeโthey represent a new frontier in regenerative skincare. Still, like all aesthetic treatments, their safety and effectiveness depend entirely on whoโs using them, how theyโre applied, and where they come from.
So do your homework, ask questions, and trust providers who care more about outcomes than buzzwords.
???? Listen to the full conversation:
???? John Oliver, Salmon Jizz, and the Science Behind Salmon Sperm (Medspa Mayhem)
???? Read the book: Medspa Mayhem by Dr. Kate Dee โ available everywhere books are sold
We are incredibly honored to be recognized two years in a row in The Seattle Timesโ Best in the PNW awards!
These awards are particularly meaningful to us because they are decided entirely by the community. Your votes, loyalty, and trust have helped Glow Medispa grow and thriveโand we couldnโt be more grateful.
Organized annually by The Seattle Times, the Best in the PNW contest celebrates top businesses across a wide range of industriesโfrom healthcare to hospitalityโthrough public nominations and voting.
Each summer, readers across the Pacific Northwest cast their votes over a two-week period. The winners are then announced both online and in print in the fall.
We are proud to be recognized for our clinical excellence, patient care, and commitment to results.
Voting for the 2025 Best in the PNW recently closed, and weโre once again feeling so grateful for everyone who took the time to vote for us. Your ongoing support continues to drive us, and we hope to celebrate another exciting win with you when the results are announced this September.
As a medical spa, our focus is on results-driven, research-backed aesthetic careโwithout ever losing sight of the personal attention each patient deserves.
We specialize in a wide range of treatments, including:
All services are delivered by highly trained medical professionals and master estheticians in a welcoming, supportive environment.
Our 2023 Best Customer Service win across all industries was a powerful reminder that great care goes beyond the treatment room. From your first call or consultation to your post-treatment check-in, our goal is always to make you feel comfortable, cared for, and empowered.
Winning in both 2023 and 2024 is something we donโt take for granted. It inspires us every day to continue elevating our standards, investing in education and innovation, andโmost importantlyโtaking great care of our patients.
Whether youโre new to Glow or a long-time regular, thank you for being part of our journey.
We invite you to schedule a consultation and experience the care, quality, and results that earned us these honors.
Call, email, or book onlineโweโd love to welcome you.
In this episode of MedSpa Mayhem, Dr. Kate Dee discusses the advantages of direct primary care with guest Dr. Steffie Deeds, an internal medicine physician and founder of her own direct care practice. The conversation covers the broken traditional insurance-based healthcare system, the benefits of direct primary care for both physicians and patients, and the practical implementation of this model. Dr. Deeds explains the difference between having insurance and receiving actual care. The episode also delves into women's health issues, particularly around hormones and menopause, debunking myths and emphasizing the importance of proper treatment. The show highlights how physicians like Dr. Deeds are transforming patient care by focusing on long-term relationships and personalized medicine.
Reach out to Dr. Dee
Email Dr. Kate Dee at info@drkatedee.com
Check out the Medspa Mayhem website for
Purchase Medspa Mayhem on Amazon
Find out about the Medspa Board
Reach out to Dr. Stefie Deeds
00:00 Introduction to MedSpa Mayhem
01:11 Meet Dr. Stefie Deeds
02:26 Understanding Direct Care
03:28 Challenges in Traditional Healthcare
06:17 The Benefits of Direct Care
17:56 Hormones and Menopause
22:52 The Shift Towards Treatment
23:07 Challenges in Accessing Care
23:28 Risks of Non-Guideline Based Care
24:55 Compounded Hormones vs. FDA Approved
27:42 Supplements and Their Efficacy
28:37 Personal Experiences with Hormone Therapy
30:07 Testosterone and Libido
31:38 Discussing Menopause with Your Doctor
37:45 Community Engagement and Education
39:32 Conclusion and Contact Information
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