Meladerm and Fraxel Laser Treatments

The active ingredient in the Meladerm is kojic acid which is a natural skin lightening cream.  I have had some success with this in my practice, but it is still unclear as to it's overall effectiveness and dependability relative to hydroquinone.  You do have to watch for skin hypersensitivity with prolonged use of the kojic acid preparations.  I basically have the patient use the kojic acid for about 2 weeks before a treatment. Stop several days before and resume one week after for the Fraxel re:store.  I presently do not use it on the re:pair unless there are early signs of PIH.  The protocol is not as scientific as we would like it to be because there are no definitive studies that I am aware of and we treat by anecdotal success.