Pixel laser: is this laser an effective melasma treatment?

Question

Hi, I have melasma under my eyes and on my forehead symmetrical. This appeared when I was pregnant 7 years ago and has never gone I was taking an antibiotic for acne called tetralysal for many years also. Im wondering if pixel laser will work on my discolouration or aggravate it and end up worse off. Any advice would be much appreciated. Thanks

Anil R. Shah, MD · Answer

Greetings, please see options below. Melasma is a condition which requires multiple steps and treatments to effectively improve the condition consistently over time.  In our office, here are steps which are effective:
-Pico lasers- The best type of laser for improving the condition.  Please not it takes multiple steps to improve melasma safely
-Nd:YAG Nano lasers with toning- Here a laser is used for deeply resistant melasma to break up particles without generating excessive heat
-Melanage peels- A variety of peels can work and melanage is one of the best for melasma
-Skin topicals- A variety of products including use of lighteners (we prefer natural lighteners such as arubtase found in our product Luminoso) as well as sunscreens can help improve the condition
-Lifestyle choices-Avoiding the sun, hormonal changes (we have a hormone expert in Dr. Chughtai in our office) can all impact melasma.
While melasma is common, patients must understand a multi pronged approach is often the best strategy and controlling this condition.
Best, 
Anil Shah MD

Raffy Karamanoukian, MD, FACS · Answer

Pixel may cause hypo pigmentation. I would start the Melarase Brightening Kit followed by Clear and Brilliant and light chemical peels. Best, Dr. KaramanoukianLos Angeles

Jason Emer, MD · Answer

Clear + brilliant, peels, microneedling/PRP, aerolase, sometimes erbium laser (coollaser) are the treatments of course in our practice for melasma.  There is no cure for this condition but you can get improvement that we can maintain with a series of combination treatments.  Best, Dr. Emer.

Hratch Karamanoukian, MD, FACS · Answer

Pixel laser is fractional laser technology and not optimal for the relief of hyperpigmentation associated with melasma. 
Melasma needs long term commitment with skin care and avoidance of skin factors such as sun exposure (Spectrase Sun Block) which has wide UV spectrum and SPF 30+ protection. 
Daily good habits with topicals may well help you chieve your goals with a good skin system like the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 
Melarase AM is non hydroquinone based. 
Clear + Brilliant laser can be added once you start your pretreatment with topicals. 
Best
H Karamanoukian MD FACS

Davin Lim, MBBS, FACD - Account Suspended · Answer

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. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams. Yes, Pixel has been reported to help, but I prefer more cost effective and gentle lasers to reduce the chance of rebound melasma. 
In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient. 
  
All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia

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