Four weeks ago I underwent a halo fractional treatment to reduce melasma. My melasma has since darkened?

Question

I am 33 years old with light olive toned skin, I have some freckles as well as melasma above my upper lip and checks. I have since been advised that I need to undergo 2-3 BBL treatments and an additional halo fractional treatment in five weeks. I am concerned I am not being properly advised and this course of treatment may worsen the condition. I have been going to a cosmetic surgery practise although a technican has been treating me and I have never been seen or reviewed by the surgeon.

Omeed Sani, MD · Answer

Hello,
Melasma is mainly considered a hormonal rather than a skin condition. It also may require different treatment plans to achieve a reasonable result. Skin maintenance and avoidance of risk factors such as direct sun exposure, regular use of sun block will be essential to control Melasma. We always start with a medically graded chemical peel that is designed for melasma condition.  BBL or any light based laser treatment might make this conditions worsen. Since the introduction of Halo, We have treated melasma patients with great results and no complications. We always start them on the prescription strength bleaching cream for two weeks before and up to 4 weeks after.  
Best of luck

Kristine Romine, MD · Answer

Thank you for your question.  Melasma is a challenging skin condition and
it is imperative that you seek out proper treatment as some therapies will
worsen the condition, especially for those with darker complexions.  An evaluation from a board certified
dermatologist who has extensive experience in cosmetic & laser dermatology
is important.  BBL treatments area a
great way to even out hyperpigmentation and “freckles/solar lentigos” which are
induced by the sun.  However, caution
should be used if you have melasma. Sometimes BBL or other photofacial/IPL
treatments can worsen melasma.  Please
ask you technician what the plan will be if this happens.  In my office, we have a peel that is great for
melasma so if one my patients wants the multiple benefits of BBl and ends up
with a flare of melasma, we can clear it nicely with the peel.  In my experience, we have never had any
worsening of melasma with Halo. Best of luck to you.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. As has been already stated, melasma can be a very tricky skin condition. I treat my patients with hydroquinone prior to and after treatment to help suppress the production of melanin. Halo treatments can really help patient's melasma while it will exacerbate it in others. Seeking the advice of a dermatologist may be beneficial in your situation. Best of luck!~Dr. Sieber

Quenby Erickson, DO, FAAD, FACMS · Answer

Thank you for your question. Firstly, if you have not been evaluated by the physician prior to treatment, I do not think you are in the right place. In my office, we frequently do light halo treatments for melasma. I have found them to be very effective. More aggressive halo treatments can be associated with more heat and I have seen rebound darkening from this. BBL treatments have been known to exacerbate melasma and therefore I do not think that is a good recommendation for you. I strongly encourage you to seek out treatment from a board certified Dermatologist, as Dermatologists are the skin experts and are best trained to give you good treatments for your melasma. Finally, melasma is a very tricky skin issue and many treatments that work on some can cause exacerbation in others. There is no cure, but it can be significantly improved with proper care, but will likely always wax and wane and require intermittent treatments.  Best of luck to you.Sincerely,Dr. Quenby Erickson

Davin Lim, MBBS, FACD - Account Suspended · Answer

Erbium and non ablative wavelengths - IPL - BBL are NOT good treatment options for melasma. The mainstay of treatment is with SPF, HQ bleaching creams. Low dose lasers such as Q Switch, Pico, or the Clear and Brilliant are better solutions. Melasma is recurrent, and a prevention program MUST be in place after fading the pigmentation. More on this condition in the resource below. Dr Davin Lim. Brisbane. Australia.

Four weeks ago I underwent a halo fractional treatment to reduce melasma. My melasma has since darkened?

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