Photofacial Melasma

A doctor referred specifically to fair-skinned patients for Photofacials. I am Asian and have darker skin. Is it true that Photofacials tend to make discoloration (melasma) worse? What would you recommend I use for my skin problem?

Doctor Answers 6

Photofacial melasma

It is very risky to treat someone with melasma with photofacials.  I recommend starting with a topical hydroquinone first.

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 172 reviews

1110 112th Ave NE
Bellevue, WA 98004

Melasma treatment is difficult in darker skin

Melasma in a common problem in darker or "ethnic" skin.  There is not universally effective treatment, and yes, some treatment such as IPL can induce clinical worsening.  I find it best to approach melasma treatment with a combination approach using topical treatment (e.g hydroquinone), laser or phototherapy, and chemical peels.  Each treatment should be designed specifically for individual patient. Most importantly, you will need to find a physician with an ample experience in treating darker skin types with melasma. 

Chang Son, MD
Fort Lee Dermatologist
3.0 out of 5 stars 2 reviews

2083 Center Ave.
Fort Lee, NJ 07024


You are right that in many cases, you can get worse outcomes with a photofacial on melasma.  We prefer to start with chemical therapy first, and use light as a last resort.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 12 reviews

360 Rose Ave
Danville, CA 94526

Very few things make the melasma better

Dear Bambi

Your concerns are appropriate. Photofacial works best when there is a big color separation between the background skin and the issues to be treated. In your case, the color separation between your darker skin and the slightly darker melasma is minimal. Generally it is not possible to make a difference without also treating the natural skin color. Additionally, many individuals with darker skin find that the photofacial will stimulate hyperpigmentation. It is important to be aware of these issues. The melasma can be difficult if not impossible to treat. The important issue here is to not harm the skin in an effort to improve it.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.5 out of 5 stars 21 reviews

9001 Wilshire Blvd
Beverly Hills, CA 90211

IPL treatment basics: How to improve results for photofacials and melasma

Melasma must be treated with a combination of photofacial and topical skin creams to reduce bioactivity of melanocytes.  I recommend that patients use Melarase during IPL treatment.


Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

804 7th Street
Santa Monica, CA 90403

IPL for the Asian patient

Intense pulsed light can be provided for a limited subset of Asian patients (those with very light skin). It is crucial that the physician have experience with Asian skin as it is true that IPL / photofacials can darken skin in certain situations. Bleaching creams and some chemical peels can improved melasma, but may not completely eliminate it.

Peter Schmid, DO
Longmont Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

1305 Sumner Street
Longmont, CO 80501

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.