Photofacial Melasma

A doctor referred specifically to fair-skinned patients for Photofacials. I am Asian and have darker skin. Is it true that Photofacials tend to make discoloration (melasma) worse? What would you recommend I use for my skin problem?

Doctor Answers 8

Melasma/photofacials/asian skin

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Yes you can darken melasma with a photofacial in asian skin. I prefer to pre-treat asian skin with hydroquinone (occasionally compounded with retin-a) for a month or 2 and then follow up with retinol or glycolic peels. Also, I will do microneedling for melasma in asian skin as it is safe for all skin types. It is best to consult with a board certified dermatologist to see what your best option is- All the best, Anita Gill MD 

The Woodlands Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Can photofacials darken melasma in Asian skin?

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Yes,  photofacials can darken melasma in Asian skin.  Topical hydroquinone and/or a number of chemical peels should be tried first as these are safe for all skin types.  If the desired result is not achieved then a photofacial or profractional laser that specifically does not target melanin can be tested in a small area of the melasma to determine the result.

Robert Sleightholm, MD
Brampton Plastic Surgeon
5.0 out of 5 stars 11 reviews

Photofacial melasma

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It is very risky to treat someone with melasma with photofacials.  I recommend starting with a topical hydroquinone first.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

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Melasma treatment is difficult in darker skin

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Melasma in a common problem in darker or "ethnic" skin.  There is not universally effective treatment, and yes, some treatment such as IPL can induce clinical worsening.  I find it best to approach melasma treatment with a combination approach using topical treatment (e.g hydroquinone), laser or phototherapy, and chemical peels.  Each treatment should be designed specifically for individual patient. Most importantly, you will need to find a physician with an ample experience in treating darker skin types with melasma. 

Chang Son, MD
Englewood Dermatologist


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You are right that in many cases, you can get worse outcomes with a photofacial on melasma.  We prefer to start with chemical therapy first, and use light as a last resort.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Very few things make the melasma better

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Dear Bambi

Your concerns are appropriate. Photofacial works best when there is a big color separation between the background skin and the issues to be treated. In your case, the color separation between your darker skin and the slightly darker melasma is minimal. Generally it is not possible to make a difference without also treating the natural skin color. Additionally, many individuals with darker skin find that the photofacial will stimulate hyperpigmentation. It is important to be aware of these issues. The melasma can be difficult if not impossible to treat. The important issue here is to not harm the skin in an effort to improve it.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

IPL treatment basics: How to improve results for photofacials and melasma

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Melasma must be treated with a combination of photofacial and topical skin creams to reduce bioactivity of melanocytes.  I recommend that patients use Melarase during IPL treatment.


Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

IPL for the Asian patient

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Intense pulsed light can be provided for a limited subset of Asian patients (those with very light skin). It is crucial that the physician have experience with Asian skin as it is true that IPL / photofacials can darken skin in certain situations. Bleaching creams and some chemical peels can improved melasma, but may not completely eliminate it.

Peter Schmid, DO, FAACS
Longmont Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.