Would you recommend Clear and Brilliant for Dermal Melasma?

Question

I have had dermal melasma since my first child was born. I've tried hydroquinone combined with Retin-A and glycolic peels with no success. Two clinicians have told me I am not a candidate for laser treatments (because of PIH risk), but today I met with a doctor who suggested I try the Clear and Brilliant Laser treatment. I have olive complexion and of Mediterranean decent. Is this superficial laser really a good choice? After doing some reading, I'm not so sure. What have other people found?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Michael Dobryansky, MD, FACS · Answer

Hello and thank you for your
inquiry. Unfortunately, there is no definite answer to your question. As you
know Melasma is systemic and I see you have been battling with it for quite
sometime. Usually when we have patients with this condition, we will start you
on our ZO Skin Health Multi-hydroquinone Therapy Program for at least 4 weeks
before the treatment. After seeing how your skin is progressing, we will
determine whether it is safe to perform the treatment. If you have responded
well, we can start a series of Clear & Brilliant treatments at a low
setting and progressively work our way up if necessary. The Clear and Brilliant
is a safe controllable fractional laser, so your risk of Melasma worsening is
decreased vs. other lasers. Its worth a try to see if it helps improve the
hyperpigmentation. But keep in mind this is something long term and its very
important to wear and SPF 365 days a year and avoid sun exposure as best as
possible. I hope this helped answer your question.

Mary P. Lupo, MD · Answer

Those of us who treat a lot of melasma know there is no one device that is a home run in every patient, but Clear and Brilliant, with conservative settings, can give great results. It is a good idea to have your dermatologist carefully evaluate your skin for an underlying vascular component to the melasma. When present, C and B is riskier and low level Excel V would be preferable.Good luck.

Andrea Hui Austin, MD · Answer

Hello there,In general, I caution the use of lasers for the treatment of melasma, but you can certainly ask your doctor to try a test spot before treating your whole face. Clear & Brilliant would be my choice for those with melasma - and I would treat conservatively.Melasma has many different causes, and must be approached this way. One common cause is hormonal imbalance or use of hormone medications such as oral contraceptives or supplements. Please be sure to check in with your internist to make sure everything is ok. If you are using any unnecessary supplements, stop those. Sun exposure is another important trigger of melasma. Be sure to wear a mineral sunblock every day, and re-apply throughout the day if possible. The ingredients you should look for include: zinc oxide, titanium dioxide, and ferrous oxide. Powder sunblocks are a great addition to your daily routine. You can even take supplements such as Heliocare, which provides internal sunblock, or niacinamide, which can decrease the uneven pigmentation and any inflammation. Wear a hat and/or use umbrellas when you walk outside.Next, at-home prescription and physician-dispensed treatments can help. Medications like Triluma contains a lightener (hydroquinone), retinoid (tretinoin) and anti-inflammatory (fluocinolone). Usually my patients use a medication like this for 4-6 months until they achieve their aesthetic goals, and then we transition to a tretinoin-only product. Procedures such as chemical peels can also help. Please caution use of lasers, as this can cause worsening of melasma if done incorrectly. Of course, good skincare is very important. Use gentle cleansers and moisturizers, and avoid using acids at home, which can irritate the skin. Good luck!

Would you recommend Clear and Brilliant for Dermal Melasma?

Answers (4)

More Clear and Brilliant Questions

Clear & Brilliant laser for wrinkles and fine lines under the eye and crows feet?

After Clear and Brilliant Treatment, is Microdermabrasion Recommended or Necessary a Week After the Treatment? (photo)

What is best for large pores, Clear and Brilliant Vs IPL?

Clear & Brilliant Laser Treatment w/Accutane?

Yes or No to Clear and Brilliant Lazer?

WE SEND PRETTY
EMAILS