Which would you recommend; IPL laser or Chemical Peels for Melasma? (photos)

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 (Cool Laser) to get the best results. See an expert for a formal evaluation. Best, Dr. Emer

Dark pigmentation on the skin can be due to melasma, age spots, and sun damage. Melasma is a specific hormonally-influenced skin condition in which pigmentation is deposited by overactive pigment cells in your skin.

In our office, we individualize treatments for melasma and skin discoloration based on skin type, skin complexion, hormonal influences, and ethnicity.

Treatments for melasma begin with Melarase creams as follows:

MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Additional therapies include fractional laser, fractional RF, Covalent peels, and LED microneedling with Replenish serum. The video demonstrates the clear and brilliant laser that is used alongside Melarase creams.

Best, 

Dr. Karamanoukian

Realself100 Surgeon

Chemical peels are a better treatment option for melasma. There is a chance that IPL may actually worsen melasma in the long run. Broken capillaries need to be treated with laser. Fine lines and wrinkles may be treated with either Botox or laser.

These 3 problems with the addition of facial sun damage due to sun exposure (age spots) are the most common facial discoloration and aging problems that patients face when they come to see me.My preferred method to treat melisma is to utilize an IPL. If used in the adequate way, it is able to improve dramatically the problem of melasma in a very quick and effective way. Maintenance will be by utilizing a cream that contains hydroquinone and a sun block.Broken capillaries may be also traded effectively with IPL and/or other vascular laser in a very effective way with minimal worsening of the melasma if the treatment is performed in a very conservative fashion.The treatment of fine wrinkles could require resurfacing. This might worsen the melasma if it is aggressive. So my recommendation would be to treat fine wrinkles with medical grade skin care products and avoid laser or any other form of aggressive resurfacing because it might worsen your melasma despite the improvement of the wrinkles. My mentor always said that you need to be wise at which fight you pick. I think that the treatment of the melasma will give you much more satisfaction in the long run than the treatment of the fine wrinkles. Hope this help you,Dr. Diaz

Unfortunately there is nothing that will treat all 3 problems at the same time. However, you can treat at least 2 together. IPL using the correct machine can correct the melasma and the telangiectasia (broken capillaries). This will take several treatments about a month apart and the treatment will have to be repeated every several years even if you do wear a zinc oxide UVA blocking  sun block daily. Use of skin rejuvenating creams can markedly improve both the melasma and the fine wrinkles. The best product that I have found is the Obagi Nu-Derm system which uses hydroquinone, an alpha hydroxy, Retin-A and a zinc oxide sun block. As you continue to use this intermittently, you should maintain the correction of the melasma and the wrinkles should continue to improve. Peels could be used to speed the improvement after 3 months use of the Obagi, but I do not recommend them without its use first as there is a significant chance of worsening the hyper pigmentation. For the same reason I would not use a laser.

I prefer gentle treatments for melasma. Obviously the cornerstone of treatment is with sunscreens, hats and sun avoidance. From there I would use HQ bleaching cream 5-7% for 3 months. I would add Glycolic peels, and IF you want wrinkle reduction as well, add Q switch laser at a skin toning setting of 1064 nm. You need 8-10 treatments-this will firm up your skin and fade the melasma as well. I would stay away from IPL as this can easily worsen your condition. RegardsDr Davin LimLaser and aesthetic dermatologistBrisbane, AUSTRALIA