ProFractional Lasers Effective for Melasma?

Melasma is a tendency to brown pigmentation of the skin, especially in women ( & particularly those who are pregnant or are on birth control) and those with naturally darker pigmentation. While ProFractional laser works well for melasma, the concern is that the melasma can recur if one gets pregnant again or has too much sun exposure. Bleaching creams and chemical peels, along with excellent sun protection are critical; if these fail, then profractional should be considered, with the understanding that the melasma could still recur (as its not a tendency we can cure).

I firmly believe that lasers should be the very last resort for the treatment of melasma. The cornerstone of melasma management is avoidance of hormonal factors (if possible) and the use of high factor spf 3-4 times per day. This includes hats and tints. Secondly we use fading agents, such as Lytera and if possible HQ (Hydroquinone). Simple, low cost chemical peels such as glycolic acid, Vitamin A, Lactic acid , very low strength TCA peels can help with epidermal melasma. If laser were to be used here is my preference-1. Q switch laser2. Fraxel 19273. Copper Bromide combined with above for the erythotelengectatic variant of melasma (red and brown)4. Fractional lasers. I have treated many melasma patients with Profractional laser before, some respond, some don't, some worsen, most recur. Medical treat is the best way forward.RegardsDr Davin S. Lim Laser and cosmetic dermatologistBrisbane, Gold CoastAUSTRALIA