Melasma and PIH Treatment - what is the best laser treatment for these? (photos)

Question

I have melasma and PIH and have been treating it with hydroquinone and Enlighten Peels plus extreme sun protection.. I would like to continue treating it this summer with hydroquinone and the addition of a laser. Which laser would be best? Would the PicoWay help? What is the best laser to treat Melasma and PIH?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Nissan Pilest, MD · Answer

Thank you for your question. Pico laser can work really well on both Melasma and PIH and is very safe. We also sometimes recommend light chemical peels that are effective at sluffing off superficial PIH. I would use hydroquinone for no longer than 3 months and consult a local Board Certified Dermatologist for best next steps.

Best of luck.

Regards,

Nissan Pilest, M.D.

Best of luck.

Regards,

Nissan Pilest, M.D.

Amir Bajoghli, MD · Answer

Lasers can be tricky in treating melasma and post-inflammatory hyperpigmentation (PIH) and in some cases can worsen the appearance of melasma. When choosing lasers to treat melasma, PicoWay Resolve is one of the safer options and it can be used in conjunction with treatments such as UltraMelanage (a superficial chemical peel designed to improve the texture and appearance of skin) to provide significant relief. Melasma is a chronic condition that can return with even minimal sun exposure so it is crucial to maintain sun protection before and after treatments.

Melasma and PIH Treatment - what is the best laser treatment for these? (photos)

Answers (3)

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