What is best for melasma and broken capillaries on ethnic skin?

I would use a combination of Melarase Brightening Kit followed by light Limelight IPL to help prep the skin and remove dark discoloration and capillaries. Best, Dr. Karamanoukian#Realself100 Surgeon

I suggest seeing an expert, since there is no cure for melasma you want something that gives improvements and maintains them.  Best, Dr. Emer.

Melasma is very different that superficial hyperpigmentation or age/sun spots.  Any heat produced device will worsen the melisma and make it darker.  Melasma is very difficult to treat and requires multiple modalities and a lot of patience. Importantly, one must avoid direct sunlight completely. The best laser device for melisma, even darker skin and ethnic skin, is Endymed 3Deep. It breaks down the melasma without heat to destroy melanocytes.  In conjunction a 4% hydroquinone with kojic acid used in the evening is very beneficial to speed the process. Although we compound our own skin lightening agents based on our patients' needs, Obagi Nuderm Clear 3 has been proven to be very effective over course of time and affordable.

Melasma can not be completely
cured, however effective treatment are possible. This is because your skin is
extremely sensitive to UV and even the smallest amount can stimulate your
pigment cells to produce colour. The mainstay of treatment is strict UV
protection- hats, sunglasses and SPF every 4 hours.

I prefer to use a combination of
creams and laser for melasma. Hydroquinone can be used (5-8%), along with
vitamin A creams. I usually start my patients on laser (low dose Q switch or
Picosure) a few weeks after they commence on creams.

In some cases I combine glycolic
AHA peels, and in other cases I use a tablet called Tranexamic acid to help.As for broken capillaries, V Beam or Excel V can help, but the parameters can be tricky in darker skin types, - I suggest you seek the advice of a Board certified Dermatologist or Plastics for this. 

All the best,

Dr Davin Lim

Laser, surgical and aesthetic
dermatologist

Brisbane, Australia