How does Halo and BBL compare to PicoSure/picodiscovery lasers for melasma?

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. See an expert for a formal evaluation. Best, Dr. Emer

Thanks for your questions.  This is one of the most frustrating things as a consumer.  What is best?  Unfortunately, much of your results are dependent on the power of the laser, how it's maintained, what settings are used and the technique of the provider.  You could go to another provider to get a Halo & BBL treatment and get completely different results.

Thanks for your questions.  This is one of the most frustrating things as a consumer.  What is best?  Unfortunately, much of your results are dependent on the power of the laser, how it's maintained, what settings are used and the technique of the provider.  You could go to another provider to get a Halo & BBL treatment and get completely different results.You need to find the best experience.  Find a physician's office close to you with lots of treatment options and excellent reviews.  Make sure that they have experience treating PIH & melasma on Asian skin.  We use the PicoSure laser with the FOCUS and Flat Lenses and a unique protocol to very successfully treat melasma.  That doesn't mean that it will be the correct answer for you.  It sometimes takes a little trial and error to find you what best for YOU!  I hope this helps.

HALO is not a good treatment for melasma, but is excellent for skin pigmentation and low downtime skin rejuvenation in skin type 1-2, for skin type 3 - I prefer Pico in the settings of 6 mm Focus 0.71 handpiece and power. Melasma is a MEDICAL condition and laser is only a tool to manage one aspect of this complex disorder. I do find that Pico is superior to nano lasers however its more complex to use. The X factor is not the device, its the dermatologist or plastics behind the laser itself. Melasma is a very common cause of skin pigmentation. It 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. This forms the foundation of all treatments. 



I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’) 



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 according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher. 

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin. 



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