Does Piq04 laser work for the treatment of melasma?

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 skin brightening topicals such as Luminoso is great to help lighten pigmentation and even out skin tone. 
It is important to know that melasma is a moving target and requires patience and diligence to treat.
Best,
Anil Shah

Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + Brilliant, peels, microneedling/PRP, Aerolase, and sometimes Erbium (Cool Laser) to get the best results. See an expert for a formal evaluation. Best, Dr. Emer

however ,it is much harder to find a Picosure laser because they are expensive to buy. This laser is much better than an IPL if you have an ethnicity to your skin.you should pre-treat with 4-8% HQ for 10-14 days before starting the Picosure laser sessions. You should plan to do 3 picosure laser sessions, each spaced a month apart. you need to be religious about wearing sunblock when you are out in the sun.david berman md