Can Microdermabrasion Remove Melasma?

Question

I have had 6 Microdermabrasion treatments and do not see a significant improvement.  I'm concerned. I may be paying for a service that will not treat Melasma and want to know what treatment will address this?

Nick Slenkovich, MD · Answer

I would not recommend microdermabrasion as an effective treatment for melasma. Melasma is a deep, resistant form of hyperpigmentation. Microdermabrasion exfoliates exfoliates the skin at a superficial level, so it would be unable to reach the damaged skin cells. To correct melasma, it is necessary to reach the dermis of the skin, where the melasma is contained.

	The best approach for treating melasma is a combination of a prescription topical regimen and chemical peels. The topical regimen should include a hydroquinone product with a minimum of 4% strength, and a tretinoin product at a strength appropriate for your skin type and condition. Hydroquinone helps to suppress the overactive pigment-producing cells, and tretinoin exfoliates the skin and repairs cellular damage while helping to drive the hydroquinone deeper into the skin. There are several good skin care lines that offer products which include these ingredients in various forms, so there are options available to suit your particular needs and preferences. As for chemical peels, there are different types of acids that will help this condition. In this instance, the depth of the peel is more important than the particular peeling agent used.

	As with any procedure, it is very important to work with a practitioner who is very skilled in administering the particular peel that they are providing. This becomes even more important with a more aggressive procedure. There are a few very good peels on the market right now that have been designed specifically to treat melasma, and have also been formulated to improve patient safety.

Anil R. Shah, MD · Answer

Hello, please see below for effective 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 note 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

Raffy Karamanoukian, MD, FACS · Answer

Microdermabrasion is an superficial treatment and cannot change or alter the functioning of a hyperstimulated melanocyte.  I would recommend melanocyte cellular control with the Melarase AM and Melarase PM products. Our practice specializes in melasma treatment in Los Angeles. Raffy Karamanoukian MD FACS

Stephen Prendiville, MD · Answer

Microdermabrasion is a technique which involves cleaning the outer layers of skin from the epidermis. The pigmentation with melasma is much deeper. Your observations are correct: Microdermabrasion won't help much if at all. Melasma is a challenging problem to treat with any topical, IPL, or laser based therapy.

Eric M. Joseph, MD · Answer

Microdermabrasion is helpful for refreshing and exfoliating your skin. We often combine this with a light glycolic peel to enhance your results.
I have tried IPL PhotoFacial treatments for melasma with unsatisfying results.
You should consult a board-certified dermatologist familliar with melasma treatments to discuss your options.
I hope this is helpful for you.

Shlomit Halachmi, MD, PhD · Answer

Melasma is discoloration of the upper cheeks, upper lip, or forehead, most commonly seen in women of childbearing age.  It tends to develop during pregnancy (hence its nickname "the mask of pregnancy") or while taking a birth control pill.  Regardless, its onset is triggered by the combination of estrogen and sun exposure.  No sun - no melasma.
Melasma is like a light switch, except one it is turned on, it can't be turned off... Stopping birth control pills will not make the melasma resolve completely.  After all, you still make estrogen...
That does not mean melasma can't be treated successfully.  The key is to avoid sun exposure strictly: avoid the sun in peak hours, use a broad-spectrum, high SPF (50+) sunscreen, applied liberally, and reapplied often, and wear a hat with a good brim.  Studies show that this alone is the main factor in reducing the darkness of melasma.  
You can also see a dermatologist to discuss treatments such as hydroquinone, which blocks the key enzyme that makes melanin, the brown pigment in the skin.
Avoid treatments such as peels and laser - these may provide temporary benefit, but the melasma will always come back.  In addition, those treatments may in themselves cause change in your skin color (post-inflammatory hyperpigmentation).

Promila Banerjee, MD · Answer

Melasma pigments are spread throughout superficial and deeper layers of the skin.  Microdermabrasion is too superficial to help your melasma.  Save your time and resources for a deeper laser like, Halo Hybrid Fractional Laser which effectively and safely reduces melasma.  It has been FDA approved since 2014.  Our patients love this treatment after having tried many other therapies for Melasma which were ineffective.
Best wishes, Dr B

Anteneh Roba, MD · Answer

Microdermabrasion will not remove the melasma. Microdermabrasion is a superficial treatment used to remove the very superficila skin layers. While melasma is a condition which affects the deeper layers of the skin. There are much better options to treat melasma.

Renita (Lourdhurajan) Rajan, MD, DNB · Answer

Microdermabrasions do not work for melasma. There are many, more appropriate options, including chemical peels, and of course, the newest and quite effective picosecond pigment removal lasers, like the Picoway.

Robert F. Gray, MD, FACS · Answer

Melasma is a difficult skin condition to treat and often requires many treatments. Bleaching creams, good skin care, sunscreen, IPL treatments, Retin-A are some of the first treatments. It can be very challenging to treat but I have found very good results with most patients by starting with this regimen.

	Good Luck!

	Robert F. Gray, MD, FACS

Can Microdermabrasion Remove Melasma?

Answers (12)

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