I agree with Drs Rapaport , Fox and Lim - treating Melasma is safe, when done correctly. The discrepancies are rooted in the highly variable responses we see with melasma patients. Melasma is a complex skin condition, involving 1) overactivity of the melanocytes, the cells that produce pigment, and 2) irregular deposition and degradation of the melanin pigment in the dermal and epidermal layers of the skin. Any treatment that disrupts the skin can trigger the melasma and have an unwanted outcome, so caution is warranted. Best outcomes are achieved with conservative management with topicals like hydroquinone or kojic acid, or gentle peels, but can include gentle MN RF, when indicated.
Clinical improvement has been shown with the technology of high-intensity fractionated radiofrequency (HIFRF) microneedling. Studies show that the intense heat delivered directly into the sweat glands in the dermis disables or destroys them. Effect lasts 12 - 14 months. I use the Morpheus 8 handpiece by InMode Technology and get great results after 1-2 sessions. Depending on the area of treatment, palms, soles, or axillae, we charge around $725 - $900 per treatment session. I hope this was helpful. My best to you, Dr B
Great question. This is a common problem and can be remedied in several ways. These lines are caused by one or all of the following: strong muscles around the mouth, loss of mid-face/cheek volume, and sagging skin. Depending on what specifically is causing your lines, I usually recommend a combination of Botox for strong downward muscle motion, RF (radiofrequency) thermal treatments for skin tightening and lift, a touch of filler near the cheek bone for volume and microneedling with delivery of PRP or exosomes to renew the skin. I see beautiful results with this approach.
There is a new terrific option for sagging skin on the forehead and eyebrow area. The new RF (radiofrequency) technology that heats the dermal layer creates an immediate brow lift and forehead tightening with one treatment, and can be done once a week until there is a lasting effect. I recommend a series with the Forma wand or the Morpheus 8 hand piece and see fantastic results. Because skin laxity and sagging are caused mostly by loss of the collagen and the ordered structure in the dermis, tightening occurs when thermal disruption of the aged scaffolding stimulates new collagen formation and fibroblast contraction. I hope this was helpful. My best, Dr B
Great question. There are some wonderful new options. I see really nice results with a series of radio-frequency (RF) treatments and microneedling with intradermal PRP or exosome delivery. For my patients, I also recommend an aggressive anti-aging skin regimen and ways to improve skin health and nutrition. You will look 5-10 years younger in 4-6 months.
