What is the best treatment for Melasma if I have an olive/Mediterranean complexion? I'm not dark at all however.

I have used prescription bleaching creams and in the long run it's not much of an improvement. I have used the Obaji system and it's not much better. Would Fraxil help? If so how many sessions?. And what are the costs in California?

Doctor Answers 5

Best Treatment for Melasma

I would definitely avoid lasers for Melasma and seek out a physician who is an expert and uses Cosmelan.  You will have the best cosmetic results.  Best, Dr. Green

What is the best treatment for Melasma if I have an olive/Mediterranean complexion? I'm not dark at all however.

Thanks for your query. fraxel wont help that much for pigmentation but ndyag will. You can go in for revlight ot 1064 ndyag that will improve the pigmentation and you alter it with chemical peels. hope it helps.

All The Best

Ajaya Kashyap, MD
India Plastic Surgeon
4.9 out of 5 stars 132 reviews

Melasma treatment options

Melasma is a common but difficult problem to treat with no cure. It requires lifelong treatment. Once a patient understands and accepts this, then I  offer several different treatment options. I find combination treatments work best. Topicals including hydroquinone, chemical peels, and adequate sun protection (sunscreen, hats, sunglasses, etc) are important part of any melasma treatment plan. I also like low energy, low density laser treatments such as the Clear + Brilliant Permea combined with C E Ferulic from SkinCeuticals. Fraxel, in most cases, is too strong of a treatment for melasma and may make it worse in some cases. It is important that you see an expert. 

Melasma treatment is usually conservative

The first mode of therapy is alway good topicals (skincare) and chemical peels. Sun protection is key. I even advocate Heliocare, an oral supplement that is an antioxidant and reverse damage from sun exposure. You have to know there is no cure for melasma. Lasers are reserved for failures and can actually make things worse in some cases. The Spectra QS laser has an FDA approval for melasma and involves a series of 8-10 treatments. Some docs are advocating PRP but I haven't seen their before and after photos to prove this works yet.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

Try a Combination--Clear + Brilliant and microneedling/prp for melasma

We currently use clear + brilliant with bleaching and microneedling/prp and get amazing results. I suggest you see an expert. You will need lifelong treatment, sun protection, skin care. But these treatments can give you improvement and then you maintain. Costs will vary, but see an expert. Best , Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

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