Will Pixel CO2 Treat Melasma?

Hello! I've been recommended the Pixel CO2 by an aesthetician in Manhattan. I've heard mixed reviews about this and am concerned I'll have adverse effects. What are your preferences with regards to Pixel vs. Fraxel Dual (which from my research seems to be one of the frontrunners). Pros and cons of each? Thank you! I'm desperate for help.

Doctor Answers 2

Pixel treatment and melasma

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I would strongly advise against having a Pixel procedure done if you have melasma because of the risk of worsening your melasma or having persistent skin discoloration after the procedure.  There are much safer treatment options for melasma with minimal risk of skin discoloration or worsening your melasma afterwards.  One of those alternatives would be conservative treatments wtih the 1927nm setting with the Fraxel DUAL, which is a non-ablative laser, as well as chemical peels, conservative Q-switched laser treatments and topical hydroquinone.  Daily use of sunscreen is also critical to help prevent exacerbation of melasma.  Often, we recommend a combination of the above for patients with melasma, but caution them that in some cases, energy-based treatments such as lasers may sometimes worsen melasma.  Since significant risks are involved with the Pixel procedure and suboptimal results may be obtained in experienced hands, it should only be performed by board-certified dermatologists or plastic surgeons who are experienced with the procedure. 

Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Pixel Laser for Melasma?

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Hi Chloe.  We would not recommend either of the lasers you are suggesting.  As compared to a good hydroquinone program, lasers are more expensive, more time consuming, cannot "cure" the condition and have the potential to make the Melasma worse.  

We use many different lasers, including q-switched lasers, which are commonly used in Asia for Melasma.  We have had some success with the treatments, but in about 50% of cases, the Melasma gets worse.  Lasers take a lot of treatments, get very expensive and do not work better than our 8% hydroquinone program.

It's important to understand that Melasma is typically a chronic (non-curable) condition that requires constant treatment.  An at home program like hydroquinone can work very well.  Our program is 8% liquid format that penetrates very easily without the irritation caused by Retin A.  It works well over a three month period, and because it is high strength, we take our patients off of it one month out of every four.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

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.