Does IPL make melasma worse? What’s the best laser treatment?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian

IPL does not typically make melasma worse, although it doesn’t treat it effectively either. There are some very good laser options to manage melasma symptoms, including the Clear and Brilliant and PicoWay lasers. Make sure you are working with a board-certified dermatologist who has expertise in treating melasma to ensure the most effective treatment plan. Keep in mind that melasma is chronic, so the focus is on managing symptoms and not curing the condition.

Hello Danielle.  We are always surprised at how many practices propose laser or IPL treatments for Melasma.  Melasma is a CHRONIC condition, which means it has no cure.  Lasers and IPL are an expensive and time consuming treatment that will not yield anything but very short term results (less than one month).   Your case is not unique in that lasers often bring on Melasma or cause it to get worse.  Instead of a combination approach, we would suggest one thing and one thing only, hydroquinone.  We use an 8% hydroquinone (max 90 days and then 30 day break) to control and minimize the effects of Melasma.  The product yields excellent results (see photos at link below) without the higher cost or risk of laser treatments.  We have both q-switched lasers and IPL and would never use them to treat Melasma because we see how often they cause Melasma to worsen when our patients try other facilities. 

Hi Danielle, melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + Brilliant with peels, microneedling/PRP, Aerolase, and sometimes Erbium (Cool Laser) to get the best results. See an expert for a formal evaluation; our practice is located right here in Los Angeles. Best, Dr. Emer

IPL is a great treatment for pigmented lesions, capillaries, rosacea and collagen stimulation. In my practice I do not use IPL for melasma. I like to use fractional laser on a very low setting, prescription bleaching agents and sun protection.
Good luck.

In our clinic, we used a combination of prescription and nonprescription skincare combined with sun protection and gentle laser treatments for melasma control. I prefer to use Clear + Brilliant Permea for melasma. IPL will help with the epidermal component of melasma although not the deeper (dermal) pigment. Picosecond lasers like Picoway are also helpful with melasma. 

I’ve achieved great outcomes using Halo laser at deeper/lower temperature settings. With multiple treatments most Melasma can be minimized. I combine this with an amniotic membrane derived growth factor topical that I apply after to help augment wound healing, modulate inflammation levels and stimulate healthy collagen growth. 

IPL can help minimize epidermal pigmentation which may be a part of your melasma.  Most pigmentation associated with melasma is deeper. Often times, melasma is best “controlled” with topicals (sun protection, anti-oxidants, retinoic acid and bleaching agents).  Lasers can be tried but there are many patients that are non responders even to laser.  We have used Picosure Focus lens and Thulium laser (Lasemd glo).  Melasma can never be cured so it can be frustrating.