Is the Halo laser or Erbium laser better? I'm 39 with brown spots on cheeks. (Photos)

Halo is a better option when it comes to hyperpigmentation and skin laxity. Erbium laser is a type of laser that is already in the Halo handpiece. Erbium lasers help soften the texture of the treated skin.   IPL or BBL treatments are better for redness. However, going in for an evaluation will be better to learn which treatment is the best for your skin. 

Great question!  I recommend you consider getting the BBL and Halo combo treatment by Sciton. BBL will address your concern with redness and the Halo will address any pigment and laxity.  You should always prep your skin prior to any laser treatments for optimal results.  Please consult your provider for recommendations. Hope this helps.

Halo by Sciton is a fractional hybrid laser with 2 types of lasers in the same holes- 1470nm which is a non-ablative fractional laser and 2940nm which is also called erbium and is an ablative fractional laser. Erbium lasers are made by different manufacturers and come in full field or non-fractional in which 100% of the area is treated or fractional like in the Halo in which a fraction or % of the area is treated. In your case based on the limited photos I would use Halo. We were one of the development sites for Halo and have alot of experience with it. Amazing laser and I have been treated with it many times.

HALO is a great laser for skin rejuvenation, but is NOT the best method to treat melasma. Melasma should be managed MEDICALLY with lasers used as adjunctive treatments. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments. 



I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’) 



In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher. 

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin. 



All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.