PicoWay laser for Melasma on ethnic skin?

Question

Hello, I am half black/half caucasian and I started developing severe Melasma on my cheeks. I wanted to try the PicoWay laser but was told that it could flare up my Melasma. Is that true? I thought it was safe en darker skins color.

David Shafer, MD, FACS · Answer

Melasma can be a frustrating skin disorder brought on by spikes and drops in hormones, usually estrogen.  One of the side effects of birth control or pregnancy can be Melasma (also known as "pregnancy mask.")Pico Way laser is safe and effective to treat melasma on all skin types.  Combination treatments are essential to the success of treating melasma.  These may include:  brightening serums like Lytera 2.0 by Skin Medica twice daily, hydroquinone therapy, mineral based sunscreen and microdermabrasions or peels to prep the skin.In addition, at my practice I encourage patients to limit exposure to not only sunlight but heat such as in Hot Yoga.  The skin responds to this heat as if it is in danger and the melanocytes darken in reaction to the heat.Mixing modalities and changing lifestyle habits ensures great outcomes if expectations are properly managed.By the way, Pico Way laser is also great for tattoo removal and their signature laser facial Pico Resolve.  Pico Resolve uses their dual depth 3-D Fractional Technology to improve pigment, pores and texture.  Hope this helps.  Good luck.

Stanley Kovak, MD · Answer

Thank you for your question! It is true that the Picoway is safe for darker skin tones. When treating melasma with the Picoway laser, we use the Resolve handpiece which does a fractionated approach to pigment removal. Melasma is unusual because it has many potential causes. It may be caused by hormones, UV rays, or even heat. The biggest issue treating with any type of laser is the fact that there is heat present which causes inflammation and can cause hyperpigmentation or a melasma flare up. If your provider uses the Picoway laser to treat your melasma, they need to be sure to use it on a very gentle setting in order to try to avoid excess heat which can lead to a flare up. There are other laser options to treat melasma, though. In my office, I prefer to use the Viva laser for melasma treatment. I hope this helps!

Mark Taylor, MD · Answer

A picosecond laser like the PicoWay or DiscoveryPico can help Melasma, but lasers alone are usually not enough.  Melasma is a complicated condition that requires good sun protection, topical bleaching products, lasers or anti-inflammatory creams to treat the fine vessels and possibly 4 months of treatment with an oral medication called transenamic acid which has recently been shown to be very helpful in the treatment of Melasma.  The Cosmion Mask and Skin Brightening Gel 8 can also be very helpful.

PicoWay laser for Melasma on ethnic skin?

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