The Truth About Laser Treatment For Melasma

Melasma is a common condition causing brown, dark brown or even black-ish pigment changes on the skin. Melasma usually involves the face of women (though men can be affected too!). Those with southern Mediterranean skin, Middle Eastern skin, Chinese skin, Indian skin and African skin types are most commonly affected. Many people are misdiagnosed with melasma when they have other conditions. For example, the patient in this photo actually has a flat age spot on her cheek, the melasma is the subtle pigment closer to her nose!! To learn more about melasma and melasma treatments, click here.

The results you get from laser will be dependent on if your providers level of training, experience and understanding of how different skin types and colours will react to laser treatment. For tips on how to get results from laser skin treatment, click here 

Here are a few important things to know about laser treatment for melasma:

Laser alone will not remove melasma
The target of laser treatment for melasma is the pigment cell – the melanocyte. While it may seem easy to target it with laser, melasma is much more complex than that. Other cells and skin structures are involved in the skin making excess melanin and these also need to be targeted through treatments. So, laser alone will not help make melasma magically melt away. Other topical and physical therapies and even oral treatments might be needed to assist with the treatment of melasma.

Most people do not need laser to treat their melasma
Laser skin treatment are only need for a small percentage of those with melasma. We have hundreds of patients that we see and treat with melasma every month at Chroma Dermatology

Many patients we see have struggled with melasma and unsuccessful treatments for years before they see us and many are referred to us by other dermatologists. So, we are generally seeing more severe and more treatment resistant melasma than other dermatology centres. Despite this, most of the patients we see and treat at Chroma Dermatology are successfully managed with a combination of skin care products, topical treatments and treatments that act on blood vessels.

Stay away from IPL and BB light
IPL (or intense pulsed light) and BB (broad band) light should be avoided in people with skin of colour due to its potential to cause scarring. Furthermore, these types of light sources can worsen melasma and make it next to impossible to treat and control so should be avoided in people with melasma.

PicoSureTM laser is the safest laser for melasma in the short and long term
Without a doubt, the laser with the most scientific evidence behind it to treat melanin is the PicoSure Laser by Cynosure. This was the first picosecond laser on the market. It has a special lens that can be placed on it that creates a safe pulse of laser energy to the skin in the setting of melasma. When used with off-label settings (settings that are not part of the manufacturing guidelines), it can provide great results, no down time though there is a minimal risk of paradoxical hyperpigmentation (sudden darkening of pigmentation). The other laser that is possible to use for the treatment of melasma is the long pulsed NdYAG but the BIG warning here is that if it is not used at very specific (again, off label) settings, white confetti like spots and scarring can occur in the long term which looks even worse than the melasma itself.

The dermatologist planning your treatment needs to really understand melasma and have accumulated experience with laser devices
The dermatologist planning your laser treatment for melasma needs to think about what the laser needs to target, the surrounding skin colour, the way the skin should look just after treatment, the other medical conditions the patient may have, post treatment skin care and much more. These kinds of things can only be learned with many years of experience using laser devices combined with an in-depth understanding of the science behind why melasma occurs.

In summary, it is important to know that using laser should only be considered with other treatments fail. The choice of laser is critical for safe and effective treatments. Melasma cannot be cured but it can definitely be significantly improved in the majority of cases. To learn more about melasma, follow us on insta and facebook and check out our website.

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The information contained in this blog post is intended as a guide only and should not substitute seeking medical attention. Please see your healthcare provider for more information on suitability of products, treatments or procedures.