Will CO2 laser treatment worsen melasma?

Question

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.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

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.

Ajaya Kashyap, MD · Answer

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

Davin Lim, MBBS, FACD - Account Suspended · Answer

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

Will CO2 laser treatment worsen melasma?

Answers (4)

Answer: Yes, CO2 can worsen melasma.

Answer: Yes, CO2 can worsen melasma.

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Everything you need to know about CO2 Laser

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Will CO2 laser treatment worsen melasma?

Answers (4)

Answer: Yes, CO2 can worsen melasma.

Answer: Yes, CO2 can worsen melasma.

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.