34 with nasolabial folds and melasma. Would laser resurfacing get rid of all of the above? If so, which one? (Photo)

There is no great laser for melasma - yet anyway.  Intense Pulsed light is often used for melasma, as it can help to decrease brow spots in patients. However, melasma is deep dermal pigmentation.  Initially you may look better, but after a few weeks it can actually get darker and stay darker - called post-inflammatory  hyperpigmentation.  This can then often be lightened with bleaching agents.For melasma, you need to use regular sunscreen and stay out of the sun.  A bleaching cream with hydroquinone will often be used as well.  If you try laser, just do a small area to see how you respond.The nasolabial folds will not improve much with laser.  You can try some filler there instead.   

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question. I suggest that you move forward and consult with a board certified facial plastic surgeon. The consultation will allow you and the surgeon to choose the ideal laser. With the ideal laser in hand, we gently remove imperfections in the skin, layer by layer, revealing deeper healthier skin. Oftentimes, a combination of therapies is required both for laser skin resurfacing and for melasma.
Best wishes,

Most smile lines need a flexible filler such as Restylane® and Juvederm Vollure®, as well as a radio frequency skin tightening treatment, such as Viora®. Please consult a board certified aesthetic dermatologist for a consultation.  

The treatment of melasma often requires a combination of therapies. These include prescription creams such as hydroquinone, peels or lasers. The importance of sun avoidance and exposure is paramount. There are variety of lasers that can help such as Fraxel or CO2. There is a high likelihood of recurrence. 

Melasema is a very difficult condition to treat. While laser skin resurfacing can get rid of most of your brown spots from the melasma, they are very likely to return.  This is because the cause of melasma is more hormonal in nature and your skin is very sensitive to UV exposure.  Melasma is a chronic condition that requires constant maintenance and treatment.  Being on a good skin care regimen and having frequent peels is usually necessary.  While there is no easy cure for melasma, the condition can be managed. Be sure to make an appointment with a facial plastic surgeon, plastic surgeon or dermatologist that has experience dealing with this condition. 

Unfortunately a laser will not truly treat all of these issues - there is no "does it all" treatment. Your nasolabial folds need filler to give you the kind of improvement you desire. In terms of your melasma, this (as you know) can be very difficult to treat. Since you mentioned you have tried things in the past you may have tried IPL, however if you have not, this is a potential option that could help. The scars you mention could be treated with Sublative Rejuvenation. I recommend an in-person consult with a board-certified dermatologist to determine a treatment plan for you that fits your needs and goals best.

lasers can be used to treat the symptoms of melasma , but it is not a cure. Melasma can return especially living in the Florida sun . Laser resurfacing does not improve nasolabial folds , filler are generally used for that 

The best laser resurfacing to address melasma is the Clear and Brilliant - this is a gentle procedure, but you will require 5 sessions in addition to the use of creams such as HQ. This procedure and treat melasma, but you may require maintenance treatments as melasma is recurrent. Stay well away from aggressive laser resurfacing as this can aggravate melasma. Now, as for your nasolabial folds, speak to an expert in regard to fillers to help reduce folds. Scars can be treated with fillers if they are depressed or higher passes of laser focally. Dr Davin Lim, Brisbane. Australia.