Which laser Picosure or Picoway is more effective for melsma treatment for Asian skin type?

I recommend seeing a cosmetic dermatologist for a formal evaluation. 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 (Cosmelan), Microneedling/PRP, Aerolase, and sometimes Erbium laser (cool laser) to get the best results. I suggest seeing an expert for a formal evaluation. Best, Dr. Emer

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 micropigmentiaton. You will also be sent home with an at-home care regimen to maintain your resutls.
-------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.
It is important to know that melasma is a moving target and requires patience and diligence to treat.
Best,
Anil Shah

Thank you for your question.   I would recommend
to start using triluma morning and night six weeks prior to laser
treatment. Fractional treatment is very effective for suppressing discoloration
and evening out skintone.  Skinpen which is a microneedling device that
would also be beneficial for getting rid of melasma.  The microneedling
treatment helps to wake up your natural growth factors, shrink your pores, fade
discoloration and acne scars, and help increase collagen and elastin
production. You would do a treatment every 4 weeks and stay out of the sun as
much as possible and always wear spf 50 broad sprectrum.  Always consult
with your physician first before starting a treatment.