Unfortunately, there is no cure for melasma. Because of this, it is one of the most emotional skin conditions that we treat. The goal for the treatment of melasma is improvement and control or suppression of a condition that is considered chronic. With that said, there are many that claim good outcomes with lasers and/or topical products. In our opinion, lasers (including Fraxel) do not consistently provide benefits and, in many cases, the condition is worsened by lasers. Because you are of a darker skin type, this must be taken into consideration as well.
We currently have good success (improvement) with two topical regimens that we offer. Medium to darker skin types have a higher predisposition of having a negative reaction (post-inflammatory hyperpigmentation = darkening of the skin) if the topical regimen is too harsh. Be certain to choose a practitioner that will help you decide which treatment plan is best based upon your skin type, past modalities used, and ask for before and after photos of actual patients. Far too often, patients are prescribed strong topical regimens with very little patient education or monitoring. Whatever you decide, be diligent with sun protection daily by using a broad spectrum sunscreen.
