Samantha Fisher, MD

To answer your question it really depends on multiple factors, what kind of melasma you have, what type of laser was used, what your skin type/color is, and what laser settings were utilized. There are multiple types of melasma, superficial, deep, and mixed. The majority of melasma I see is the mixed subtype.  Some lasers such as intense pulsed light (IPL) can worsen mixed or deep melasma. In addition, if you have a darker skin type and a higher setting of the laser is used, this can induce post inflammatory hyperpigmentation or pigmentation as the skin heals. In general I recommend wearing a daily broad spectrum sunscreen, hydroquinone products such as Tri-Luma in the evening (but for no longer than 4-5 months), and would recommend consulting your dermatologist regarding a series of light chemical peels, such as glycolic acid peels or Jessner's peels to lighten your pigmentation. In addition the 1064 nm ND:Yag laser can be used in some cases with improvement. Without evaluating your skin or knowing which laser was used it can be difficult to determine what would be the appropriate course of treatment for you, I would recommend seeing a dermatologist to evaluate your skin to determine what the best option would be for you! 

There is no age in particular in which has been determined as a specific age to start Botox treatments. It is a great preventative treatment to prevent etched in lines from forming. When placed in certain locations, such as the middle of the forehead (glabella) and lateral eyebrows, Botox relaxes the depressor muscles of the forehead allowing for the muscles that elevate the brows to take over, creating a lift. Make sure you see a board certified dermatologist or plastic surgeon to do the procedure; if the Botox is placed in the wrong areas it could actually worsen the hooded appearance of your eyes. Good luck! 

In general Retin-A is a great cream to use early on to help to build collagen, even out skin tone, and help texture of the skin and fine lines. Even with consistent Retin-A use at the right potency it can take several months to correct fine lines. However, I would not expect Retin-A to completely reverse or make a visible difference in a deep nasolabial fold. For this you may want to consider a hyaluronic acid dermal filler such as Restylane or Juvederm. With the right injector and correct anesthetic preparation the injections can be relatively painless and can give you immediate improvement! 

I don't see that there would be any contraindication to Botox or Dysport with your condition. Patients with neuromuscular disorders, such as myasthenia gravis and Lou Gehrig's disease should not use
Dysport or Botox because underlying muscle weakness might worsen. 

Its normal after Botox injections to have a small amount of swelling in the areas injected, but this usually resolves within 24 hours. If you had blue discoloration in the injection areas you may have had a small bruise, this usually resolves within a few days. I'd recommend wearing sunscreen if you are going out to the pool or beach! It does take approximately approximately 3-5 days to see the results of Botox, but can take up to 2 weeks to see the maximum effect. At two weeks if there is still some muscle movement more units of botox can be injected; however if you have lines present at rest these are not likely to resolve with Botox alone. These lines present at rest are best addressed with a superficial hyaluronic acid filler such as Belotero or Restylane.