Hyperpigmentation and melasma - what can help with the dark spots on my face? (photos)

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

​Hyperpigmentation of any kind needs a combination approach of peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly,; lasers like Clear + Brilliant, Aerolase or Laser Genesis; radiofrequency like Venus Viva; and constant skin care and sun protection. Bimonthly facials with SilkPeel DermalInfusion are essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. If you have acne you can do additional treatments and peels to get more improvement. Hypopigmentation will need more of an evaluation and possibly additional lasers to get improvement. I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.​

Hi Thriving!
Let me first commend you for seeing a dermatologist for this!
A series of Clear and Brilliant treatments with the Permea handpiece would likely help you! Another option would be a series of picosecond laser treatments (for example the PiQo laser). The latter is a bit more effective (in my opinion), but, the former is also a great option. Regardless, I'd recommend that you start on a twice daily home regimen of medical grade (topical) skin care, as this will act synergistically with your laser treatments to give you the absolute BEST results! Don't be discouraged, everyone's skin is different and some hyperpigmentation is trickier to treat than others. But, I've cleared skin with a lot more hyperpigmentation than yours, so don't lose confidence that this can be improved!
Hope this helps!
Dr. Kiripolsky

I would suggest that you stop triluma immediately. There are some people who reacts badly to hydroquinone. Treatment for melasma is multimodal approach, oral medication combined with topicals such as retinols and laser would be the best approach to controlling melasma.