Will Fraxel Remove Long-Term Melasma Pigmentaion?

Before the age of 17, I had clear and beautiful skin.Then I started noticing a small dark spot on my upper left cheek, just right below the left corner of my eye. As the years went by, the dark spot spreaded across my entire left cheek and on the bridge of my nose. I am now 30, and I have to wear very thick concealer and maximum coverage powder just to hide it. I did close to 10 treatments of photo rejuvination, and it didn't do much at all. Will Fraxel be able to help me?

Doctor Answers 9

Fraxel good for melasma - but not perfect

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fraxel laser can be very helpful for melasma -but no treatment results in complete or permanent removal so continued sun protection and use of skin care products for melasma are essential. I usually combine Fraxel restore with long pulsed alexandrite laser (Gentlelase) in the same session for best results - even use that combo on my own melasma!

Charlotte Dermatologist

Best Treatment for Melasma: Fraxel Dual Laser

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Orange,

Fraxel Dual is the best laser treatment for melasma.  Patients should treat their skin with NIA-24 skin strengthening moisturizer for a few weeks before and then continue to use it after their laser treatment.  It may take from 1 to 3 treatments for optimal results.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Only the Fraxel Dual is worth trying

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is the only form of fractional non-ablative technology that I have seen consistent melasma results. Pre and post treatment from your dermatologist as well as vigilant sunblock use are musts.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Melarase or Obagi with Fraxel laser for melasma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fraxel can help the appearance of melasma, but should be used in conjunction with skin lightening creams such as Melarase or Obagi or the like. Raffy Karamanoukian, Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Effective long term treatment of melasma requires an effective short term treatment and a long-term maintenance program of skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In my hands, the best treatment for melasma involves an aggressive short term treatment to get rid of the pigment and then a long-term skin maintenance program to keep the pigment away.  Short I recommend two or more treatments with the Fraxel Restore 1550nm laser spaced about two weeks apart.  In between Fraxel Restore Laser treatments, I recommend using the Cosmion Iontophoretic Rejuvenating Mask three times a week for one hour each treatment.  This mask infuses 20% ascorbyl glucoside (Vitamin C) into the skin using a proven medical process called iontophoresis.  A 0.5mm needle wheel is used before each mask treatment to enhance infusion of the Vitamin C.   For daily maintenance skin care, I recommend M2 mandelic/malic acid products (SkinCareRx.com) in 12% for sensitive skin and 20% for less sensitive skin.  These products contain long-chain alphahydroxy acids that inhibit the production of pigment in the skin.  In addition I recommend a shoulder-to-shoulder hat and an effective UVA/UVB sun block such as Laroche Possay Anthelios 60 to completely protect the face from sun exposure.  I have treated over 400 patients over the past three years with this protocol.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Melasma treatment with fraxel

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Melasma is a difficult condition to treat.  While fraxel can produce good results for this condition it can also in some situations make the pigmentation worse.  To be safe you may choose to do a test patch first before proceeding with a full facial treatment.   We have also found success using dermaceutical spot peels.  This is  a medium depth peel which seems effective and safe for melasma.  Melasma is often over diagnosed by physicians.  True melasma is bilateral and tends to recur over time.  Sun screen and skin care maintenence is important for best results.

Philip Solomon, MD, FRCS
Toronto Facial Plastic Surgeon
4.4 out of 5 stars 119 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fraxel restore and now fraxel dual have helped many patients with melasma lighten their darkened skin color patches. There is no cure, and religious sunscreen application and lightening creams help with maintenance.  You need regular followup to ensure there is no complication of using lightening creams long term. There is a risk with any external treament, that the skin may pigment darker as a response to the inflammation.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Melasma can be treated with Fraxel Dual

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
A recent study confirmed that melasma responds to Fraxel although it usually comes back. I have found that a new skin whitener called Elure is also very helpful. I do have a concern that you have the correct diagnosis though. Melasma is a symmetrical condition and you describe a lesion on the left. Make sure you see a dermatologist before proceeding to confirm your diagnosis.

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 36 reviews

Treating Melasma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It sounds like you might be a good candidate for Fraxel pigmentation treatments which, in combination with a bleaching cream program and good skincare regimen, can improve the appearance of your melasma. As you probably already know, lasers are not magic wands and will not eliminate all pigmentation, but they are an excellent adjunctive tool for combating a genetic tendency to form pigment.

Deason Dunagan, MD
Huntsville Plastic Surgeon

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.