Melasma treatment with chemical peels. How often can I get them done?

Question

I have melasma and am allergic to hydroquinone. I have tried many hydroquione free topical treatments for my conditon, but they aren't effective. I would like to get TCA peels. How often can I get them done? I want to lighten the melasma, but I want to do so safely. The last thing I want is for my skin to worsen.

Raffy Karamanoukian, MD, FACS · Answer

Our office specializes in chemical peels. TCA peels can help, but they should be performed by an expert in chemical peels. Best, Dr. Karamanoukian Los Angeles

Jason Emer, MD · Answer

I would suggest Clear + Brilliant laser treatments with VI or Salicylic Acid Peels.  TCA is very inflammatory and can cause rebound melasma.  I rarely use hydroquinone based creams for my patients, I suggest you get skin care from a cosmetic dermatologist with experience in treating melasma/pigmentation/dark skin types.  Best, Dr. Emer.

David Hansen, MD · Answer

Several light chemical peels such as jessner's soln or 10-15%TCA every 2 weeks does nice for melisma at a cost of roughly $250-350 each.

Stewart T. Cayton, MD, FACS · Answer

Melasma continues to be a difficult problem for many women. 
 The TCA peels should help but beware that this is no rookie" peel and your provider MUST have experience or you could get burned. 
 Lytera is a newer lightening/bleaching agent compared to hydroquinone.  It takes longer to work, which could possibly be why you feel that it doesn't work if you have tried it. I promise you that it does work and it also takes longer to "wear off" if you stop. This is good if you run out of product and wish to avoid the "flare" phenomenon that is often associated with stopping hydroquinone.
Also for you to consider is the PICOSURE laser.  It is one of the only lasers that are FDA-approved for treating melasma and I believe is the newest of them.
Best wishes!
Dr. Cayton

Davin Lim, MBBS, FACD - Account Suspended · Answer

Melasma is one of the hardest conditions to treat.... try this-1. Lytera nightly2. TCA 8% every 2 weeks at a Specialist clinic3. Low fluence 1064 QLS by either plastics or derm. This should help get you around your irritant- allergy to HQ. Kind regardsDr Davin LimLaser dermatologistBRISBANE, Australia.

Melasma treatment with chemical peels. How often can I get them done?

Answers (5)

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