I am considering Fraxel Dual,I need advice! I'm a male with Melasma on both my cheeks. 6 Re:fine sessions 2 yrs ago was no help.

I am an Indian with skin tone is similar to Raj of BBT . I am concerned about hyperpigmentation for brown skin My ?s 1. With precautions (apply cream, reduce sun exposure) can I reduce the chance of hyperpigmentation? 2. The Dual with the frequency 1550/1927, can they be individually tuned (change the strength of LASER) to reduce the chances of hyperpigmentation? I have read that 1927 is for melasma and since Fraxel refine (1550) was no help, can it be toned down? Thx 4 Hlp

Doctor Answers 2

Melasma Treatment

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Melasma is very difficult to treat. In my office I like to start with Cosmelan. Cosmelan (non hydroquinone) and Cosmelan MD (hydroquinone and Retin-A) are very effective on Asian, Hispanic, Caucasian, Indian and African American skin.

Treatment consists of a mask that is worn on the skin for 6-12 hours this mask includes 15 lightening agents like Kojic Acid, Azelaic Acid, Phytic Acid and Salicylic Acid. After the initial mask there is a maintenance cream that is applied to the face starting 3-5 days after the mask. The maintenance cream is used 1-2 times a day for 1 month and then every night and can eventually be dropped down to 2-3 times a week.

You can reduce the chance of hyperpigmentation; reduced sun exposure and application of sunscreen will help. The cause of Melasma is unknown but the more pigmentation your skin has the more melanocytes you have, production of melanocytes is increased when the skin is irritated or exposed to rising hormones and the sun. In fact, even a small amount of sun exposure is the main reason Melasma returns after fading.

In terms of the Fraxel strength, though the wavelength of either 1550 or 1927 will stay the same the amount of energy delivered to the skin can be adjusted. However, I would recommend you start with a Cosmelan treatment.

It is best to consult with a Board Certified Dermatologist to see which treatment is best for your skin type.

Irvine Dermatologic Surgeon
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Fraxel for Melasma

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Fraxel and Clear and Brilliant can all be used for Melasma. I wish you had posted a photo. With your skin type you would probably be best treated with Cosmelan for your Melasma. Melasma is very difficult to treat so please find a board certified dermatologist wi a great deal of experience with cosmetic procedures. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.