I have had two fraxel dual laser treatments and still have melasma spots. I was thinking about getting IPL treatment. (photos)

But scared my face will burn I burned in 2 spots from the fraxel on my lip and has left white scar marks on my lips also will the IPL get rid of the scars?

Doctor Answers 4

I have had two fraxel dual laser treatments and still have melasma spots. I was thinking about getting IPL treatment. (photos)

Thank you for your question. I typically do not recommend IPL for melasma. Fraxel can sometimes help, but also has the potential to worsen melasma. I think the best treatments for melasma are the most "mild" treatments, such as topical, at-home regimens. I would probably start with a combination of hydroquinone and retinol (and of course, daily SPF). Keep in mind, though, that melasma is a chronic condition, so you may always have periods of worsening. Hormonal shifts, sun, and heat can all play a role in worsening melasma. Best of luck,

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 34 reviews

IPL is not the best treatment for Melasma

Generally, IPL is not a good treatment for Melasma as the high level of energy has the high risk of making it worse.   Fraxel Dual can help with melasma, but about 1 in 5 patients getting Fraxel experience worsening of their melasma.  We have found that Clear & Brilliant Permea and microneedling with hydroquinine or other skinlightening agents offers the best risk/reward.  Some chemical peels are also helpful.  A daily at-home skin care regimen utilizing different skin-lightening agents, hydroquinine, retinol/tretinoin, and most importantly, tinted sunscreen is very important to keep pigment production suppressed.

Melasma and Sun Spots -- Best Treamtent Is Clear + Brilliant / Aerolase w Microneedling PRP, Pro Yellow is Useful

I have found that FRAXEL isn't that great for melasma and often causes it to worsen. My suggestion is low level laser (clear and brilliant) or RF treatments like (viva, skinfinity, intensif) with aerolase, skin care, and microneedling/PRP.  Skin care and sun protection are essential.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Better options for melasma

In my opinion, IPL can be very temperamental and can often flare melasma. IPL is unlikely to improve the scarring that occurred from laser burns. IPL can itself cause burns, and I would not recommend IPL on recently injured skin or on uncontrolled melasma.It is important to keep in mind that scars continue to change for up to 1 year after injury. Rather than rush to another treatment, it may be best to exercise patience and adhere to an excellent topical regimen that addresses melasma in addition to your other skin concerns.

Elizabeth Damstetter, MD
Chicago Dermatologist

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