Is IPL Laser the Best Melasma Treatment?

IPL is not a good treatment option for melasma.  Using a topical hydroquinone cream with tretinoin (Retin-A) may be a better option. 

We believe that IPL (and Fraxel for that matter) treatments are the worst choice for Melasma for the vast majority of those that have it. Melasma can be an epidermal (upper skin), dermal (lower skin) or mixed (dermal and epidermal) condition. We have found that the only results we have achieved for treating Melasma were achieved with Q-switched laser technology and only in cases for epidermal Melasma. But so few patients have just epidermal Melasma that many actually get worse after light based treatments such as q-switched lasers, Fraxel and IPL treatments. Every patient that has come to our office after receiving Fraxel or IPL treatments elsewhere has had their Melasma worsen after treatment.
We will begin trials shortly using the Hoya Conbio Medlite C6 (or later) q-switched laser on skin type IV patients (Asian and Hispanic). Although we have used q-switched laser technology for Melasma in the past, the results were mixed with only 50% getting better and the other half getting worse. Our new protocols will take into account research that has been ongoing in Asia for several years with much higher energies and much shorter duration between treatments. Until we complete this research we will continue to treat Melasma with topical (hydroquinone based creams) treatment programs only.