Does BBL and Halo treatment really work as it hasn't for me - what other options would treat my wrinkles, melasma? (Photos)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question and I am sorry you haven’t seen positive results thus far. Treating your skin tone requires a very customized approach, so unless the doctor you work with is a laser expert with a wide range of device options, it will be challenging for you to see the improvement you want. In my office, I work with more than 50 laser and light devices, which allows me to produce superior results for all of my patients, regardless of skin tone. That said, I might recommend a pico-second laser for you to address your melasma and rejuvenate your skin. Find a board-certified dermatologist with the experience and expertise necessary to tailor your treatment for an optimal outcome. 

In my experience, BBL would
not be a treatment I would choose for melasma as the heat from it can make
melasma worse. If a laser device is used to treat melasma, the HALO laser is
more ideal than BBL, but the settings on the Halo need to be specific for melasma.  A setting that may be used for wrinkles may
not be ideal for melasma.
I prefer to use chemical peels
for your skin type.  The two peels that I like to
use to treat melasma are: The Perfect Derma Peel or SkinCeuticals Advanced Corrective Peel.
It is also very important to speak
with your provider to make sure you are using the best skin care products for your
skin.  3 Must Haves for Anti-aging: Topical Vitamin C, Retinol and a
physical sunscreen are three things worth the investment.  To treat melasma: use a skin lightener either hydroquinone or
a hydroquinone free lightening product like SkinCeuticals Discoloration Defense or
a combination of SkinCeuticals Glycolic 10 and SkinCeuticals Resveratrol.  Hope this helps!  

you likely have genetic hyperpigmentation and melasma that needs internal hormonal optimization as well (see dr jill stocker in our practice at jasonemermd.com see "about" she does virtual consultations for internal antigaingh and IV glutathone therapy as hormonal changes in women can really affect pigmentation).  But you truly need peels like cosmelan and enlighten (see link to emeragecosmetics.com where we do free virtual skincare cosults daily and at home virtual peels). halo and BBL will not help this type of pigmentation and stronger lightening creams and a better skincar regimen are needed -- vitamin c, phyto plus, vivatia foam, faith essenace serum, and restorsea 10x.
Hyperpigmentation from any type needs a combination approach of peels like cosmelan,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.