What is the Best Laser Treatment for Dermal Melasma?

Doctor Answers 5

Best Laser for Dermal Melasma

Dermal melasma is the most difficult to treat. One needs a laser that can penetrate into the dermis, so I typically use the QS-Nd:YAG lasers at low fluence.


San Diego Dermatologic Surgeon
5.0 out of 5 stars 66 reviews

Melasma Treatment

Thank you for asking that, in my opinion, I prefer a multi-modality approach. We typically like to pre-treat with Hydroquinone products (we prefer ZO) 2-4 weeks before any laser procedure. In our office, we find that the Clear & Brilliant's Permea works most effectively at clearing up Melasma when done in a series of 3-4 spaced 4 weeks apart. Typically, you will use numbing cream 30 minutes prior to treatment, and the procedure itself only takes about 15 minutes. Afterwards, it is common to be very red, this will subside in 12-24 hours. The next day and day after your skin will feel like "sand paper" as it begins to slough off. Sun damage and Melasma may appear darker during the next week, which is also very normal, and will continuously flake off and fade over the next 3 weeks. Good luck to you!


#melasma    #clearandbrilliant    #permea

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Melasma and Laser Treatments

Melasma is difficult to treat; you have to be careful because if something too aggressive is done it can cause more damage. I have found great success with the Cosmelan and Cosmelan MD treatment in my office. It’s usually the first step I take before moving on to more aggressive treatments like lasers.

I do however use lasers on patients that are also using lightening creams like the Cosmelan, in this instance I like to use the Clear and Brilliant Permea. This treatment is gentle yet very effective for Melasma and pigmentation. Best results are seen after a series. I recommend 6 sessions done once every 3 weeks with use of a vitamin c anti-oxidant and SPF 50 in the morning and a lightening cream at night. Consult with a Board Certified Dermatologist to see which option is best for you.

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

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Lasers for Melasma

Melasma is a difficult skin condition to treat.  Constant sun avoidance is necessary to prevent recurrence.  There are many lasers that have been used and I have used the Fraxel, Clear and Brilliant, among others with success.  I also love Cosmelan which is a topical peel originally from Brazil.  There is a medical grade Cosmelan treatment which is combined with hydroquinones with great results. Please find an experienced dermatologist for the best cosmetic results.

Laser Treatement for Dermal Melasma

Dermal melasma is very difficult to treat, but I've used the 1927 nm laser (commonly known as Fraxel Dual or Clear & Brilliant) with great success. I always use the lasers with lightening medications (creams) or natural lightening products. This will enhance the results and prevent side effects. Make sure you go to a dermatologist who is experienced in treating melasma with lasers, especially if you have darker skin.

"This answer has been given without seeing the patient and cannot be held as true medical advice, only opinion. Seek an in-person evaluation with a trained medical professional for appropriate care and advice."

Anjali Butani, MD
Orange County Dermatologic Surgeon
5.0 out of 5 stars 3 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.