Smartxide Dot CO2 Laser vs Frax 1550 Laser, Which Laser treatment is better treating skin tightening, wrinkles and melasma?

Fraxel and/or Co2 are best for resurfacing, but erbium is a good alternative. I always combine lasers with microneedling/prp for more robust outcomes. For skin tightening, I recommend a combination of ultherapy with RF treatments and sculptra for skin tightening. Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + brilliant, peels, microneedling/PRP, aerolase, and sometimes erbium laser (coollaser) to get the best results. Melasma will need life-long maintenance. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

CO2 is much better than the Fraxel 1550, but the trade off is downtime. CO2 remains the Gold Standard for skin tightening. If you have melasma, the treatment of choice is neither of these lasers. Melasma can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I usually start my patients on laser (low dose Q switch or Picosure) a few weeks after they commence on creams. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams.

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia