What needle size is best for my Melasma using a Dermapen? (Photo)

Melasma is a chronic, often relapsing hyperpigmentation condition that typically requires a combination of at-home, topical prescription strength lightening medications, occasionally a prescription oral medication (tranexamic acid) combined with in-office professional treatments, such as a series of superficial peels or microneedling combined with chemical peeling agents or prescription lightening agents. And since it is a chronic, relapsing condition, topical at-home maintenance therapy accompanied by strict sun protection measures are a must to maintain the benefits of treatment and to reduce the frequency and intensity of recurrences.  It should be clear from the above that unsupervised home treatments are unlikely to prove beneficial and may, as in this case, worsen the problem by superimposing upon the melasma, post-inflammatory hyperpigmentation from the home treatment. You would be wise to seek consultation and treatment by a board certified aesthetic physician and make sure to ask to see his/her personal before and after photos. Best of luck to you and stay safe.

Hi,
Melasma is not responsive to dermapen and even with a partial response it will reappears and even look worst. you may combine the 0.5 or 1 mm dermapen treatment with application of whitening mesoserum right after dermapen to have better result.
Best regards,
Dr.Sajjadian

1mm can make pigmentation worse . you need proper skincare and lasers. a peel at home now like cosmelan or enlighten will really help speed the process up and then long term you need vivatia foam, phyto plus, bioclear cream, a really good retinol like cosmelan 2 and reve skin 1.0 and antioxidant/antiaging cream like anteagemd+accelerator (see link to emeragecosmetics.com for product Info).  in office clear and brilliant with proper microneedling / PRP is best.
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.