Melasma Treatment - should I go for BBL?

Hello Loveydovey79,As there is no cure for Melasma a lot of the treatments you are taking into consideration can only temporarily reduce the pigmentation. I wouldn't recommend preforming any light based laser such as BBL/IPL as the pigmentation may not lift after treatment. I would recommend the ZO Hydroquinone system paired with a series of Micro Needling treatments done in conjunction. Once you have finished your HQ I would then consider having a few Halo resurfacing treatments that would help lift any left over pigmentation. The awesome thing about either the Micro Needling or Halo is they will significantly help the appearance of your scars. Micro Needling causes pin point injuries to the skin that forces the body into repair mode and starts the stimulation of collagen and elastin. There is no downtime, any skin type can have treatments and can be done in the warmer months. 

Melasma can recur. I would suggest a combination of Melarase AM, Melarase PM, Melapads, light chemical peels, and Clear and Brilliant laser for your condition. Best, Dr. Karamanoukian Los Angeles

Hi LD.  The most important word you used in your question is PERMANENT.  There is no cure for Melasma so lasers will not offer a permanent solution.  In addition, the "rebound" from IPL, BBL, Fraxel and others after the treatments are stopped can mean that the Melasma gets worse.If you decide to go with a laser or IPL, understand that even if it improves in the beginning, the condition will always return and it may return darker.  We have been treating Melasma since 2004 and we know your frustration.  We happen to use 8% (liquid) hydroquinone that works very well and because of the high strength, we take patients off the drug 1 month out of every 4.  We have found this to be the most effective form of Melasma management and we never recommend lasers or IPL.To see examples of the results we have achieved, click on the link below.

Melasma is a very common stubborn condition.  While there are no permanent solutions there are many good ways to manage this condition.
BBL is probably not the best treatment for melasma as light based therapies can make the condition worse.  
I would suggest following a good skin care regime with hydroquinone based creams along with retinols. Then using a laser like Scitons to perform a fractionated laser treatment like the Halo will help to improve the degree of pigment.
Of course continued protection of your skin from light using a good sun block is very important. And it may be helpful to look into any hormone imbalances that may be contributing to the issue. 
Bhavlene Panesar MD

Melasma or facial hyperpigmentation is a very difficult
condition to treat. In our office, we use a variety of treatments including
skin care products (containing retinoic acid, hydroquinone, glycolic acids),
sunscreens, chemical peels (light, medium, deep including the blue peel), and
lasers (IPL/BBL, Q-switch, PICO, Fraxel). Unfortunately BBL alone will not be enough to get rid of your melasma.

Over the last few years, we have had good success with the
ZO® Blue Peel in treating hyperpigmentation. This is a robust in-office
procedure that provides dermal and epidermal stimulation allowing for maximal
tightening, restoration and rejuvenation of the skin. It also minimizes or
eliminates the appearance of melasma [both epidermal and dermal melasma] and
facial pigmentation. All patients require 6 weeks of skin
conditioning prior to the procedure with the ZO Hydroquinone or
Non-Hydroquinone kit. 

These are advanced techniques so be sure to get an
experienced dermatologist or plastic surgeon consultation for recommendations
and treatment options. Since you are in Calgary, if you haven't see us yet, get a free cosmetic consult by calling us at 403-271-3627 to assess you.