What are your opinion on fillers/Botox with melasma patients?

The appearance of your melasma should not be worsened with Botox or fillers, whether done in the glabella or your nasolabial folds.

Thank you for your question. Botox or dermal fillers should not worsen your melasma. Ensure you discuss your concerns during an in person consultation with a board certified plastic surgeon. Best, 

In general, injectables would not be expected to make melasma worse.  Melasma treatment typically involves medical therapy and, less commonly, laser.  In the event your skin is red or irritated from either of these treatments (or some other reason), I would wait until it returns to its baseline color before undergoing injections. 

Botox or filler injections should not impact or affect melasma, so you should have no problems if you'd like to have your frown lines treated. Melasma is typically influenced by a variety of other factors including sun exposure, hormonal changes (i.e. through pregnancy or oral contraceptive use), and genetics or family history.

Neither botox or fillers will have any effect on worsening melasma. Rarely , fillers could cause an inflammatory response called post inflammatory hyper pigmentation at the site of injection  .This is a reversible phenomenon that can be treated with bleaching agents such as hydroquinone  and does not cause the melasma to worsen.

Neither Botox nor dermal fillers should have any effect on Melasma.  Melasma may typically worsen with sun exposure and hormonal changes.

There should be no problem injecting fillers or Botox in areas that are affected by melisma, as these procedures have no effect on pigmentation of the skin.

Melasma is a a problem of the upper layers of the skin, & can be improved by sering your dermatologist. As far as both Botox & Fillers are concerned, they have NO EFFECT , whatsoever, on your melasma. Just , as a side note, we rarely fill the nasolabial folds per se , as was the trend a few years ago. Have an experienced injector analyse your face properly, to determine where the filler needs to be placed. Usually, it is the cheeks that need the reflation. Best of luck.

     Melasma is a pigmentation disorder with a characteristic pattern of excess pigment (melanin) in the superficial and deeper layers of the skin.The excess pigmentation can be potentially increased by a variety of factors including sun exposure, hormonal changes, and many other types of inflammation.Because any skin injection can potentially lead to inflammation from bruising or the injection process, some potential stimulation to produce more pigment is theoretically possible but is not common.I would suggest that you consider a daily medical skin care regimen that reduces the possibility of increasing your melasma thru the appropriate use of medical cleansers, sunscreen and topical products that suppress hyper pigmentation such as antioxidants and hydroquinone.These products should be recommended by an experienced skin care professional in order to be safe and effective.It is also important to seek out a very experienced and credentialed physician or nurse injector because the technique of the procedure is critical to achieving optimal results with less chance of bruising, inflammation and other complications.

My patients are thrilled with correcting their nasolabial areas with fillers such as Restylane, Juvederm, or Sculptra.  Botox and filers will have no effect on melasma.  Melasma is a dermal process that is due to to a combination of sun damage and hormones and can be corrected through hydroquinones and creams such as Cosmelan.  You do not have to worry that your melasma will worsen from having facial injections. Please consult a board certified dermatologist for the best cosmetic results.