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.