Which is a better treatment for melasma: microneedling or a chemical peel?

Question

I have light melasma on my forehead and hyperpigmentation on my cheeks. Is it better to have a chemical peel or microneedling? I have very sensitive pale skin and want to make sure the treatment I choose doesn’t cause even more hyperpigmentation.

Anil R. Shah, MD · Answer

Melasma is one of the most difficult skin conditions to treat as it is triggered by hormones and exacerbated by heat. What this means is that while most pigmentation issues respond well to lasers such as IPL, Melasma has a tendency to get worse after heat is exposed to the area. Here are my recommendations for treating Melasma, good luck.
------Chemical Peels- Peels such as the Melanage Peel or the Reve Peel offer safe results for patients with Melasma. A combination of acids and non-acids penetrate the skin to lift micropigmentation. You will also be sent home with an at-home care regimen to maintain your results.
-------Lasers- The safest way to treat melasma via laser is with a laser that fires in Picoseconds. This is to insure a careful heating of the skin not to further exacerbate the melasma. Here in my office we use the Piqo4 Laser by Lumenis. It is the only laser proven to treat melasma safely and effectively.
Using a skin brightening topical like our Luminoso cream is great to help lighten pigmentation and promote an even skin tone.
It is important to know that melasma is a moving target and requires patience and diligence to treat.
Best,
Anil Shah

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

Jason Emer, MD · Answer

Hyperpigmentation from any type needs a combination approach of peels like cosmelan,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer

Anteneh Roba, MD · Answer

Both treatments can help pigmentation issues however you will get better results with a targeted peel treatment coupled with a home topical facial regimen.

Michele S. Green, MD · Answer

Cosmelan is by far the best treatment for your melasma, especially with your skin type.  I would not recommend microneedling as a treatment for melasma.  Cosmelan is a series of two chemical peels which is designed with a bleaching cream and Retin-A product to treat your skin at home between peels.  Please consult an expert in Melasma and Cosmelan treatments for the best cosmetic results.  Best, Dr. Green

Which is a better treatment for melasma: microneedling or a chemical peel?

Answers (6)

Answer: Which is a better treatment for melasma - microneedling or chemical peel

Answer: Which is a better treatment for melasma - microneedling or chemical peel

Answer: Melasma and Best Treatment

Answer: Melasma and Best Treatment

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Which is a better treatment for melasma: microneedling or a chemical peel?

Answers (6)

Answer: Which is a better treatment for melasma - microneedling or chemical peel

Answer: Which is a better treatment for melasma - microneedling or chemical peel

Answer: Melasma and Best Treatment

Answer: Melasma and Best Treatment

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Recommended reading

Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.