Can Fraxel Dual make melasma worse? (Photo)

Thank you for your question. Melasma is a tough condition to treat and will continue to come back as soon as you get too much sun exposure. Heavy SPF and avoiding the sun helps the most. Fractional laser treatments can work well for most patients along with Chemical peels. Consult with a Board Certified Plastic Surgeons office for a treatment plan that will work best for you.

Melasma is difficult to cure. The treatment you have outlined is a common treatment we use in our practice. If the heat energy from Fraxel is too high for the skin it is possible that it'll get worse although this is not a common outcome. 

Melasma is a very difficult condition to cure because it requires the patient to continue to stay out of the sun and practice strict sun avoidance.  The Triluma protocol combined with chemical peels has a great deal of success.  I prefer Cosmelan since the results are achieved much more quickly and will only require two treatments.  For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with melasma and cosmetic procedures.

There is no cure for melasma but it can be faded and controlled.  The first part of treatment is to avoid any sun exposure on your face.  Pre-treatment with Triluma can help prevent post-inflammatory hyperpigmentation which can occur after laser or chemical peel treatments.  You should have some success in fading the melasma but it will recur if you have sun exposure.