Fraxel vs Halo for dark skin (mideteranian) patients who are prone to melasma?

In those with melasma, fraxel and halo are a no-no.  These are not good for that scenario.  Hyperpigmentation from any type needs a combination approach of peels like cosmelan,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

Thank you for your question! I use Fraxel all of the time and special care must be used for patients who are prone to melasma.  Recently I have seen several patients whose melasma was worsened through Pico and other lasers.  I prefer eMatrix for dark skinned patients or those prone to melasma since the laser is "color blind" and I am able to treat all skin types. Best of luck! 

I use Fraxel all of the time and special care must be used for patients who are prone to melasma.  Recently I have seen several patients whose melasma was worsened through Pico and other lasers.  I prefer eMatrix for dark skinned patients or those prone to melasma since the laser is "color blind" and I am able to treat all skin types.  Best, Dr. Green

Halo is fully customizable to treat darker skin types and reduce the risk of melasma. I have treated Melasma using Halo and seen great results. 
Halo uses a 1470nm wavelength for targeting the deeper layers of skin and a 2940nm as an ablative to remove the top layer of skin. These wavelengths have significantly better absorption than other lasers so less energy is needed to achieve the same effect. This translates to less heat, less trauma to the skin and less risk of scarring or developing melasma.
With patients prone to melasma the target depth is deeper, which reduces the heat, and the ablative component actually helps release trapped heat and accelerates the clearing of the collagen that is targeted by the laser. 
Halo has a temperature monitor that can help minimize skin temperature during the treatment by administering the treatment slowly and evenly. 
Halo can be adjusted to treat various percentages of the skin, which is usually decreased for patients with darker skin or increased risk of melasma. 
Lastly, I like to use Amniotic Membrane over the face after a Halo treatment for Melasma because it helps with minimizing inflammation, accelerating healing and transforming scar tissue. 
In the right hands, Halo can be safe and effective for all skin types and would be a better choice over the older technology used in Fraxel.