Treatment for dark laugh lines: I have really dark brown/red laugh lines around my mouth. (Photo)

Question

Hello, I believe it is melisma? Are there any treatments for this? Also, what is causing this, please help!

Raffy Karamanoukian, MD, FACS · Answer

Dark spots on the skin are caused by sun UV exposure, hormonal load, birth control pills, and genetics. If you’re thinking about dark spot correction or melasma correction, you would be best advised to start with creams that control the production of melanin before starting lasers or chemical peels. I recommend Melarase creams first for pigment correction, followed by a protocol of lasers, chemical peels, exfoliation, IPL, and pulsed dye laser. 
  
 
  
Recommended Creams: Melarase Brightening Kit
  
MelaClenz
  Melapads
  Melarase AM
  Melarase PM
  Replenish Retinoid Cream
   
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Hooman Khorasani, MD · Answer

This is a good question and great picture!  I would first recommend if you haven't already start using a broad spectrum sunscreen. In addition to that I would start with minimally invasive therapies, like tri-luma or hydroquinone.  You must use sunscreen at the same time as the other therapies. Some lasers that have been used but with mixed success is the Alex 755nm Q switched nanosecond laser or the picosecond alexandrite laser.  However, for the best answer I recommend you see a board certified dermatologist or plastic surgeon with cosmetic training.

Jason Emer, MD · Answer

pigmentation can be treated with a combination of peels, skin care, and lasers like clear and brilliant or venus viva.  Best, Dr. Emer.

Daniel Barrett, MD · Answer

Dear Tangeriiine,I would have to examine you but Melasma can be treated with a comprehensive approach.  Stopping or changing the birth control medication, avoidance of UV and direct light, and also retinol and hydroquinone treatment. You should always use sunscreen.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

David E. Berman, MD (retired) · Answer

you should plan at least 3 treatments, each spaced a month apart. you need to use an excellent sunblock between sessions and thereafter. You may want to look if you are on any hormone therapy as well.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Closer examination needed, but most likely Melasma around the upper lip.Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments.
I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’)
  
In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient. 
  
All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.

Treatment for dark laugh lines: I have really dark brown/red laugh lines around my mouth. (Photo)

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