Fraxel or hydroquinone? (Photo)

Recently visit a clinic, the doctor suggested me to take obagi (4% hydroquinone) to treat the pigment in my face. But she also suggested fraxel to treat it. What is the best for me?

Doctor Answers 7

Combination of lasers and creams

Personally I would use the HQ, and give the Fraxel a miss. I prefer using Picosure Focus on your skin type over Fraxel. The chances of PIH or skin darkening is less with PICOSURE laser. All the best, Dr Davin Lim. Brisbane. Australia. 


Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

Fraxel or Hydroquinone for Melasma?

While Fraxel Dual can be beneficial for pigmentation issues, it should be used with caution in regards to melasma, as well as patients of certain skin type

As you may already know, melasma is a notoriously difficult skin condition to treat. There is no cure available, and while there are a variety of treatments that can provide improvement, melasma can return or become worse via sun exposure, heat, and hormonal changes. Therefore when discussing treatment options, it is imperative to avoid treating melasma too aggressively too soon. Furthermore, patients of Asian descent are at a higher risk for hyperpigmentation in general, and even those without melasma should tread lightly in regards to Fraxel.   

Your melasma seems fairly light, therefore some lasers may have difficultly detecting the pigment present. It may be best to first start with topicals, such as the hydroquinone product provided to you, and see how much improvement you notice after a few months of consistent use. If after a few months you are still looking for a more significant improvement, talk to a board certified Dermatologist about chemical peels such as the ViPeel or Cosmelan, or a less aggressive laser such as Clear+Brilliant Permea. Best of luck, and be sure to wear your sunblock!

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 17 reviews

Melasma and Lasers

Hi Flying x.  It's not a perfect picture, but there does appear to be blotches or patches of pigment.  This would be more indicative of Melasma than sun damage.  If this is indeed Melasma, many times laser treatments will make the condition worse.  There is sometimes a temporary improvement but Melasma will always return because there is no cure and often the rebound effect after laser treatments means it looks darker than to start.  You would be best served sticking with hydroquinone based on what we see in the photo.  To see examples of other Melasma patients that have gone through our treatment program, click on the before and after photo link below.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Melasma -- Clear + Brilliant, Venus Viva/Intensif, Chemical Peels, Microneedling PRP

There are many treatments for melasma but no cure. I suggest you see an expert for a combination treatment evaluation to get you on a treatment plan for improvement.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Fraxel laser or hydroquinone for pigmentation

You must use sun protection, a fading product such as hydroquinone and be patient.  Light chemical peels or the Clear + Brilliant laser may speed up the lightening but Fraxel would be too aggressive for your skin type.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 21 reviews

Minor pigmentation issues in asian skin

I would try hydroquinone and Retin A for several months. Fraxel has risks in your skin type. The pigmentation is very light and difficult to treat. Also chemical peels would be of benefit.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Fraxel or Hydroquinone and Asian Skin

I treat many Asian patients and I would prescibe Hydroquinone and chemical peels for you and not Fraxel.  Please consult an expert in Asian skin.  Best, Dr. Green

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.