Halo or Omnilux made melasma worse?

Thanks for the great question. The Halo works great for getting rid of melasma, but as I'm sure you know, even if you get rid of the melasma it always seems to come back. The Halo is able to remove the pigment from the skin temporarily. The thing that causes melasma to come back is exposure to UV light. Sitting under the light could have triggered the melasma to flare. Typically after a Halo treatment it takes 6-12 months before signs of the pigment returning are evident and this happens over time as your skin is exposed to more sun light. Bleaching agents like HQ and Kojic are staples for people with melasma and if used regularly, especially along with retinol, they will definitely make a big improvement in your skin. Stick with the topical creams and you will see a big difference. Best of luck!~Dr. Sieber

HALO made this worse, coupled with blue light. It is not logical to use an non ablative laser coupled with an ablative laser to treat melasma when we all know the aetiology of the condition. Sure, fully ablative laser can treat melasma and the after picture at week two would look great, but will rebound occur? Yes, in almost 100% of cases!Melasma 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.
I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I usually start my patients on laser (low dose Q switch C6, Revlite, Pastelle, or Picosure) a few weeks after they commence on creams. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams.

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