I'm considering the Spectra laser or Fraxel Restore in treating melasma. Is one better than the other?

I suggest a formal evaluation often low level/low energy laser is best combined with skin care and microneedling.  Best, Dr. Emer.

For many patients with melasma, I recommend Intense Pulsed Light (IPL) therapy or chemical peels.  Both can be down in-office with minimal downtime afterwards.  For most patients, Fraxel is not a great option to treat melasma.  I recommend consulting with an experienced Dermatologist to get personalized recommendations.

Absolutely, high energy lasers are not recommended for melasma. There is a very high chance that CO2 Fractional lasers such as CO2 Fraxel can and will make your melasma worse. I would use creams and low level lasers to teat melasma. Melasma is one of the more difficult conditions to treat.
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.



I prefer to use a combination of creams and laser for
melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I
usually start my patients on laser (low dose Q switch or Picosure) a few weeks
after they commence on creams.



In some cases I combine glycolic AHA peels, and in other
cases I use a tablet called Tranexamic acid to help.



All the best,



Dr Davin Lim

Laser, surgical and aesthetic dermatologist

Brisbane, Australia