Is it normal for my melasma to appear significantly darker immediately after a Clear and Brilliant laser treatment? (photos)

I went to my first session of Clear + Brilliant laser treatment for my melasma. Immediately after the treatment my melasma looked significantly darker. Is this to be expected or should. This is my first session out of 5. Thank you for your time.

Doctor Answers 4

Pigmentation after Clear and Brilliant: Start Melarase creams

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Pigmentation may be highlighted after Clear and Brilliant laser. I would recommend starting Melarase Brightening products to avoid PIH and to maintain results. 


Dr. Karamanoukian

#Realself100 Surgeon

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Clear and Brilliant and Melasma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, melasma can temporarily worsen following C and B 1927. I usually place patients on a topical such as HQ to reduce the chances of rebound. The addition of Vitamin C serum after the C and B treatment is also beneficial. Oh, and never forget the sunscreen. C and B should be performed monthly, with base line photos as comparison. All the best, Dr Davin Lim . Brisbane. Australia. 

Clear and Brilliant in the Melasma Setting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Lovelygrace thank you for the great question.

Melasma is a very tricky skin condition that tends to hyper-react to laser and light. Although the Clear and Brilliant laser (particularly the 1927 nm Permea Handpiece) can be recommended for Epidermal Melasma, the risk of worsening is still there.

Thus it is highly recommended to precondition the skin, by calming the pigment-producing cells (melanocyte suppression) with a hydroquinone or kojic acid based bleaching cream for 4 to 6 weeks, prior to starting the Clear and Brilliant laser series.

In the meanwhile please contact your physician and let him or her know of your rebound Melasma. In the interim, it is imperative you avoid the sun and to always use a high SPF (>45) broadband sunscreen, as UV rays can also contribute to the worsening of this skin disease.

Best of luck, 


Shalini Kapoor, MD
Los Angeles Ophthalmologist

Clear and Brilliant and Melasma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Clear and Brilliant is a great laser but it is definitely not the treatment for melasma and hyperpigmentation can be a consequence.  Please consult a board certified dermatologist who is an expert in cosmetic procedures.  Cosmelan is an excellent treatment for melasma.  Best, Dr. Green

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.