Do IPL fotoFacial and microdermabrasion in conjunction with topicals in clinic treat melasma? (photo)

I have done 8 session of IPL and 6 sessions of dermabrasions. I don't see any improvements instead it spread more on my face. Am I getting the right treatments? Also, they don't address my skin condition as melasma. They address is as pigmentation or brown spot. Please help.

Doctor Answers 3

Melasma can be treated with combination therapy

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Melasma is a stubborn, sometimes chronic form of hyperpigmentation that can have both superficial and deep components. I recommend you have a VISIA scan to assess the depth and distribution of your hyperpigmentation.  For melasma, I often recommend a combination of topical skin lightening creams and a laser treatment such as Fraxel Dual.  This treatment is safe and effective for your skin type.

Good luck!

Bellevue Dermatologic Surgeon
4.9 out of 5 stars 43 reviews


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I would recommend that you see a dermatologist, who can evaluate your skin and do a wood's lamp evaluation, to determine the depth of the pigment. AS a dermatologist, I would NEVER recommend IPLs for melasma, as it can make the melasma worse. Please, see a qualified dermatologist to help you. I would get a thorough history of your condition, prior treatments, use of sunscreen, which needs to be worn daily, and you need to learn sun avoidance techniques such as wearing a hat when out doors, reapplication of sunscreen, etc. Topical creams may be prescribed,but you need to be reassessed elsewhere.

Gail Nield, MD, FRCPC
Toronto Dermatologist

Melasma treatment options

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Melasma can be superficial, deep or mixed. Imaging with special photography like a VISIA machine or Wood's lamp will help your dermatologist determine where the pigment lies. Some of the deep pigment is too deep for a IPL machine and needs to use deeper lasers or more agressive peels. The Silkpeel microdermabrasion machine is very helpful in getting topical agents deep into the skin to treat melasma. Sun protections is critical as you go through the process of treating melasma. In short, melasma is always challenging and is much easier to treat when it is superficial. If it is deeper then the IPL and standard microdermabrasion may not be effective and can even make it worse. Make sure that you are seeing a board certified dermatologist to manage your melasma, especially when it has not responed to other approaches

Shawn Allen, MD
Boulder Dermatologist

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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.