Fraxel on upper lip, melasma now darker. Is this normal? (Photo)

I had fraxal dkne one week ago for two spots on upper lip. Now it is dark all across upper lip. Is this normal? I am using obagi system with brightalive and brightened.

Doctor Answers 2


Yes, Fraxel and or other laser and energy devices usually worsens Melasma. Though there are reports in the literature of Fraxel improving melasma (1927, low energy, moderate density, multiple treatments), the Gold Standard of melamsa management is always medical. 

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.

More information on available treatments in the article below.

All the best,

Dr Davin Lim
Laser, surgical and aesthetic dermatologist
Brisbane, Australia

Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Melasma and Fraxel

Fraxel was probably not the best treatment for your Melasma.  I would definitely recommend you consult a specialist in melisma and consider Cosmelan and chemical peels to help restore the skin.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.