What can I do for rosacea and melasma? Is there a treatment that works? (photos)

Thank you for your question.  It appears form your pictures you have melasma not rosacea.  If topical bleaching creams like hydroquinone based products, for example TriLuma have not worked you can consider the Fraxel Dual or Clear and Brilliant Permea.  In particular the 1927 Thulium which is in both of the aforementioned lasers works extraordinarily well for pigment like melasma.  Both will require a series of treatments.  Regards, Dr. Matt Elias

Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)



To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. 





A detailed history, together with a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -





1. Lasers ( to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 





2. Creams - anti inflammatory





3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. 





4. For females- Mineral make up is recommend, over make up that contains parabens. 







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 or Picosure) a few weeks after they commence on creams.In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help.  For the best results, consult a dermatologist for both medical and laser treatment options. 





Kind regards.





Dr Davin S. Lim.



Laser Dermatologist.