Hyperpigmentation, Melasma, Redness, Sagging. Fraxel Restore Duel V. Sciton Contour TRL Laser Resurfacing?

Interested in best options & results of cosmetic procedures for my skin. Main issue is hyperpigmentation. I'm fair skinned & living in So. California has left my face spotted with a distinct tan line. Also, slight redness at sides of nose. Lastly, just entered my 40s, and I can see light sagging starting & wrinkles at corners of eyes. Had light melasma, but stopped with thyroid meds. Skin texture is good. My derm suggested Fraxel ReStore Dual Laser (if so, how many?), but would welcome opinions.

Doctor Answers 2

In my hands, Melasma and Postinflammatory Hyperpigmentation are best with a combination treatment.

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Melasma and postinflammatory hyperpigmentation can be TEMPORARILY IMPROVED, BUT NOT CURED with lasers.  In my hands I have the best long term results with combination treatment using the Fraxel Restore or Palomar 1540 Lasers to break up the pigment.  I immediately apply a full-face iontophoresis mask (Cosmion Iontophoretic Rejuvenating Mask) with high concentrations of vitamin C (Super C - Physicians Complex).  At home patients go over the skin three times a week for one month with a 0.5mm needle wheel, apply the Super C and the Cosmion Mask for one hour each treatment.  Daily skin care includes M2 skin care (MCK Labs), a large hat, Laroche Posay or Neutrogena Ultrasheer Sunblock.  I have treated over 100 patients with this regimen with excellent long term success in most of the patients.  Long term sun avoidance and continuation of the daily skin care products is necessary to maintain a good result.  Occasionally an additional course of lasers and the  Cosmion mask may be necessary if the pigment returns. 

Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Combination treatment is needed

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To address all your concerns some combination treatment is recommended.  First for the melasma, which is one of the hardest conditions to treat.  i like to use a strong bleaching cream to be used every day.  In addition, a sunscreen of at least SPF 30 or higher is needed everyday even on a cloudy day especially living in CA.  I have seen great results with the Fraxel dual, but lasers are not the perfect treatment for melasma but they will help.  The most important is your maintenance with sunscreen and bleaching creams.  For the sagging and wrinkles around the eyes, Botox works wonders.  you can use a laser to resurface some of the sagging skin as well.  With lasers, several treatments are required.

Monica Halem, MD
New York Dermatologic 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.