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.
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!
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.
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.
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.
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.