I use many of the best cutting edge lasers and light devices in my office every day. However, I am the first person to talk my melasma patients out of using these devices, and opting for less expensive options instead. This blog focuses on why!
If you have melasma, when you first get a laser or light based treatment, you might see the brown patches turn into a coffee ground material, and then slough off. At first, the results look great! However, the next time you go in the sun, you might notice your melasma comes back with a vengeance. I can’t tell you how many patients have come to me in tears after getting a series of laser or IPL (intense pulsed light) treatments at a spa, and realizing that they spent thousands of dollars only to find that their melasma is worse than it ever was.
Here’s why that happens. We know that melanocytes, the pigment producing cells, are exquisitely sensitive to both heat and light. Consequently, it seems as though most laser and light devices, even used at very low/gentle settings, prime or sensitize the melanocytes. The next time these cells are exposed to sunlight or heat, they work overtime to pump out more pigment. As a dermatologist, on behalf of my patients, I’d rather be safe than sorry. Although every melasma patient would love a quick fix, and laser before and after photos can provide that WOW they are looking for, I strongly urge you to see a provider who takes a more conservative (and often less expensive) route.
Now if you have sun damage, and your brown spots are lentigos, or sun spots, and NOT melasma, that’s a whole different story! Bring on the lasers and lights! In those cases, I absolutely love using lasers like the Fraxel laser to brighten dark spots from the sun. So, the very first and more important step is to make sure the person deciding on your treatment plan has a very good eye and knows how to diagnose disorders of pigmentation.
I’m sharing so much on melasma right here for you guys and I love the questions you have been asking. Check out my latest posts on my favorite skincare ingredients and products to address melasma and my thoughts on the safety of hydroquinone, a topical treatment often used to treat melasma.