Thank you for your question. Melasma is very difficult to treat and heat often makes it worse. Start by looking for prescription strength 4% Hydroquinone (HQ). Do not buy it over the counter or off the internet. Laws vary by state. In Texas, physicians can prescribe and dispense in office. It is difficult for me to compare PicoWay vs. PicoSure. We have been using the PicoSure for 4 years and know how well it works. The picosecond lasers were originally engineered for tattoo removal. CynoSure recognized early on the picosecond benefit to skin rejuvenation. They came up with separate handpieces and settings for rejuvenation. I have seen several complication pictures on this site from other pico treatments that we have never seen with the PicoSure. Experience with any laser makes the difference.We have been very successful using the PicoSure laser with the FOCUS and / or Flat Lenses eliminating hyperpigmentation with a series of treatments. Our protocol is a series of very low pulse count combined with using our chiller unit blowing cold air. FOCUS lens treatments have the extra benefit of reducing fine lines, wrinkles and scars. This is one of our go to treatments for patients older than 40 and worried about the signs of aging. The PicoSure laser is SAFE for ALL SKIN TYPES. Start with sunscreen every day! Once you have treated your hyperpigmentation to your satisfaction, you will probably need a follow treatment every 6 to 12 months depending your level of re-pigmentation. Best of luck.
