How to Treat Melasma After Fraxel Dual Laser 1927?

Many MDs will treat post-fraxel hyperpigmentation with broad spectrum daily sunblock, hydroquinone 4% gel and one percent hydrocortisone & perhaps a retinoid.  Melasma is very difficult to treat.  I would be optimistic and go back to a dermatologist and slowly try to lighten them up with topicals. If you no longer trust the Fraxel, sometimes regular, light, Beta-Lift peels can be helpful as well.  Avoid the sun and always wear broad-spectrum SPF. If you drive a lot, put UV... more

Melasma is always difficult to treat, especially if you have a dark complexion. Use SPF 60 every day and re-apply it if you are outdoors. Foundation make-up will also give your skin some sun protection. See your dermatologist for a prescription of hydroquinone, tretinoin cream and a mild cortisone cream which will help fade the melasma. You may be a candidate for light chemical peels as long as you stay out of the sun.

Unfortunately a paradox does exist that treatments which are designed to improve pigmentation, especially in dark-skinned individuals, may increase the pigmentation.  Melasma is a difficult procedure to treat in general. The Fraxel Dual you had, the 1927nm wavelength laser, might have caused better results if you had been pretreated with a lightening cream or if the energy levels were different. It might be worth consulting another laser specialist.  Mild chemical... more