I've had melasma on my forehead since 2007. HQ 4% worked only for a few months of the year when sunlight was nominal (I live in Canada, so easy to avoid the sun). Despite wearing sunscreen with zinc oxide 17%, my melasma always darkened during summer. I made a trip to the Weiss Skin Institute in Boca Raton Florida for mixto co2 laser resurfacing. I had it done 9 days ago by Dr. Weiss and it was the best decision I ever made. Everyone is commenting on my beautiful skin. My melasma is gone and I haven't even starting resuming HQ yet! My acne scars are also gone, and my skin looks better than it ever has in my life. I can't stop looking in the mirror. Had I known the results would be this noticeable, I would have done this years ago.
Just awful. You get the heebee geebies just sitting in the office where the receptionist/money shakedown artist hassles you for your payment before you even sit down in the office. The office itself looks like some kind of creepy, futuristic asylum with bland colors, no TV, and it's so small it's as if everyone is on eggshells just sitting there in this awkward, uncomfortable environment. Then, the doctor, I'm sorry PA, Physician Assistant, not a real doctor, sees you. Apparently, Dr. Weiss is too busy counting his money to actually see patients. So he only does the "surgeries" AKA mole removals. Every time I would go there, I would have precancerous moles, at least according to the office. They never produced a thread of evidence proving it. So, Dr. Weiss would do the mole removals, and to tell you the truth my pet rock has more personality than the Doctor. The place is just a big ripoff factory and I wouldn't wish my worst enemy to go there. For the same price you could see a real doctor instead of a PA, and believe me, Dr. Weiss is no prize once you finally meet him.
CO2 Laser Resurfacing can improve deep pores and acne scars by stimulating collagen and resurfacing damaged skin.
Botox can potentially help it but the physician completing it must be highly skilled to ensure it does not pull above the other eyebrow.
If your provider is comfortable with it, he/she could provide valium 1h before, however you would need a driver.
A chemical peel is not likely to remove a farmers tan. Aggressive sun protection including UPF clothing would be best to prevent further sun damage
Other than a wrinkle relaxer like Botox, collagen stimulators can be used including non-ablative laser resurfacing.