Lasers can be useful as adjunctive therapy for melasma. I use specific wavelengths to slowly reduce pigment production from melanocytes. Pigment inhibitors, chemical peels, vessel modifying tablets & laser wavelengths can effectively treat the majority of melasma cases.
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InstagramWhen will I see the results from laser?
With Picosure, most patients will notice lightening at 2 weeks. The best results may take up to 10 weeks as pigment needs time to shed from the upper layers of skin.
Nano or Q switch lasers take a lot longer to notice results.
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My second line lasers include older nano Q switch lasers such as the CuRAS (in my Sydney clinic). I also use vascular lasers & yellow light lasers to treat the vascular component of melasma.
In resistant cases I use the 1927 laser, namely thulium LaseMD, Clear & Brilliant & 1927 Fraxel dual. The settings are very gentle with the primary aim directed at increasing topical absorption of HQ, T.acid & antioxidants. In truth, Fraxel is not a great laser for melasma, but an excellent one to address sun damage & solar keratosis.
Last line treatment is with the Fraxel 1550 to aid in transepidermal exfoliation of deeper dermal pigment in resistant cases.