Which is safer and has more reliable results...Cosmelan or Melanage as a melasma treatment?

Greetings, please see below for treatments. Melasma is a condition which requires multiple steps and treatments to effectively improve the condition consistently over time.  In our office, here are steps which are effective:
-Pico lasers- The best type of laser for improving the condition.  Please not it takes multiple steps to improve melasma safely
-Nd:YAG Nano lasers with toning- Here a laser is used for deeply resistant melasma to break up particles without generating excessive heat
-Melanage peels- A variety of peels can work and melanage is one of the best for melasma
-Skin topicals- A variety of products including use of lighteners (we prefer natural lighteners such as arubtase found in our product Luminoso) as well as sunscreens can help improve the condition
-Lifestyle choices-Avoiding the sun, hormonal changes (we have a hormone expert in Dr. Chughtai in our office) can all impact melasma.
While melasma is common, patients must understand a multi pronged approach is often the best strategy and controlling this condition.
Best, 
Anil Shah MD

Dark pigmentation on the skin can be due to melasma, age spots, and sun damage. Melasma is a specific hormonally-influenced skin condition in which pigmentation is deposited by overactive pigment cells in your skin.

In our office, we individualize treatments for melasma and skin discoloration based on skin type, skin complexion, hormonal influences, and ethnicity.

Treatments for melasma begin with Melarase creams as follows:

MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Additional therapies include fractional laser, fractional RF, Covalent peels, and LED microneedling with Replenish serum. The video demonstrates the clear and brilliant laser that is used alongside Melarase creams.

Best, 

Dr. Karamanoukian

Realself100 Surgeon