Will CO2 laser treatment worsen melasma?

I have melasma and was treated with Spectra laser, with maintenance approximately every 3 months. I use retin-A 0.5% and hydroquinone 4%. I have had great results from the Spectra laser. I am looking into treatment for lower lid wrinkles. I currently get routine botox treatment but still have static wrinkles and a bunching up appearance when I smile. I’m considering CO2 laser for my under eye area and possibly for my entire face to treat for texture. I am 43 years old, fair skin caucasian.

Doctor Answers 3

Yes, CO2 can worsen melasma.

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Yes, it can, however in good hands, low density CO2 can be safe. The downside is that you will need multiple treatments. Safer treatments in this area including energy based microneedling combined with PRP as well as dermal fillers. 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.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia 

Melasma/Spectra/Under Eye Wrinkle Treatment? Fraxel, Co2/Erbium, VIVA, Intensif; Microneedling/PRP, Fillers/Restylane

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For melasma and under eye wrinkles, I suggest a combination approach of lasers, microneedling/PRP, fillers and skin care/peels which can improve this area. CO2 laser can worsen melasma so its very important you go to an expert for treatment. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Will CO2 laser treatment worsen melasma?

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Thanks for your query. No, the Co2 laser will not worsen melasma. It will work on the superficial static wrinkles making your skin glow. Hope it helps.

All The Best

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.