Which is right for me - Fraxel Repair, Restore, Dual?

Hi, I am Asian and have moderate melasma (hyperpigmentation). Not sure if it is epidermal or dermal, likely mixed. I've worn 30+ sunblock for over 20 yrs but have pigmentation no forehead, cheeks, over lips, and chin. I've tried combinations of hydroquinone, peels, Retin A, dermabrasion, Cosmelan, Cutera Pearl laser, none have worked. I'm learning about Fraxel laser, but would like to know which will work best for me?

Doctor Answers 6

Fraxel and treating melasma

The Fraxel repair is most likely not right you, though the restore or dual are possible options. However, as has been mentioned, it is impossible to evaluate what laser would be best for you without examining your skin personally. For melasma, a frustratingly difficult skin condition, recent studies in Asian skin have shown good results with the Fraxel restore with few complications. In any case, laser is not a great first line or sole treatment for melasma, but it can be a great adjunct to the treatment of this challenging disease.


Long Island Dermatologic Surgeon
4.9 out of 5 stars 19 reviews

Treating Melasma

Thank you for your question. Dual would be the best choice after proper skin pretreatment to reduce the incidence of post-inflammatory hyperpigmentation. I hope this helps!

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 25 reviews

Laser Therapy to Treat Melasma

Melasma is the trickiest of skin concerns that we see patients coming into our office for laser therapy. While all of the fractional devices have an FDA approval to treat melasma, we must remember that we cannot cure melasma with any of these devices and that we need to make sure that everyone understands that we can make people better, but we cannot cure the melasma forever.

We like using the non-ablative fractional devices over the more ablative devices when we begin with our patients on this therapy. So the Restore or the Dual would be best for you and even the Clear & Brilliant works well here. No matter what you do, a skin care regimen is a must, and sunscreen a must.

Consult with a board-certified dermatologist and learn the different options for you.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Asian skin and Melasma

Asian skin is very delicate skin and if you have melasma the Fraxel laser may not be the most appropriate laser for you.  I would recommend looking into Cosmelan treatments for you skin.  Please consult with a dermatologist with experience with Cosmelan and Asian skin.

Treating Melasma in Asian Women with Fraxel

A combination of pretreatment skin brightners, retinol, and a mineral based sun protection with Fraxel Dual would be an ideal treatment in a series of three for asian skin with Melasma. Although melasma is hormonally induced it can also be stimulated by UV radiation and heat therefore it is imperative that you protect your skin with a mineral based sun protectant and I would also suggest that you meet with a hormone specialist to make sure that your hormones are not at the core of your issue.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 104 reviews

Fraxel laser for melasma

It is difficult to recommend a laser without assessing someone in consultation. Having all 3 devices I can share with you that the Fraxel repair would not be indicated unless you had severe wrinkles and were willing to take the chance of having 3-6 months of post-inflammatory hyperpigmentation after your treatment. If it is melasma that you are trying to treat, I published on the use of the Fraxel Dual for the treatment of recalcitrant melasma with very successful results and less than a 20% incidence of post-inflammatory hyperpigmentation in darker skin types. Just know, there is unfortunately no cure for melasma, and it will want to return. Patients who elect to use a laser or light treatment for their melasma are classically trying to manage it, not cure it.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 66 reviews

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.