How effective is laser treatment for melasma? (photo)

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Doctor’s Answer (3)

"Doctor with interest in Aesthetics and Lasers"

Melasma is a challenging condition to treat. 

This is because there are multiple causes of melasma including sun exposure, hormonal causes (pregnancy, contraceptive pills) and genetics.

It is good that you are doing your best in wearing sunscreen and using the necessary sun protection. 

You are correct that melasma is very difficult to get rid off. In fact, melasma can be "improved and well-controlled" rather than "totally removed". 

Lasers are effective but they are not the first line treatment for melasma.

Treatment for melasma includes:

First Line Melasma treatments

  • Sun protection & sun avoidance,
  • Discontinuation of birth control pills or intra-uterine devices containing oestrogen,
  • Medical-grade whitening creams - Hydroquinone 2/4% daily for up to 6 months or Triple Combination creams 

Second Line Melasma treatments

I usually consider second line melasma treatments if there is no response from first line treatments after 6 months. 

  • Azelaic acid
  • Kojic acid 
  • Ascorbic acid
  • Niacinamide
  • Arbutin

Third Line Melasma treatments

  • Glycolic acid peels
  • Lasers like Nd:YAG lasers
  • Oral tranexamic acid

Most of the time, creams and chemical peels can already give you good improvements for melasma.

Beyond the marketing hype, Lasers should be used for stubborn melasma that does not improve despite other types of treatments (creams/peels). 

The key for melasma treatment is to find a doctor who is experienced in treating pigmentation because melasma treatment is a long journey. I liken it to a marathon, not a sprint!

Hope this helps! Warmest regards,

Dr Justin Boey

Melasma is a tricky condition to treat as there are many factors involved and the pigment can be situated superficially, deep in the skin or a combination of both superficial and deep.

However, there are treatments available to treat this condition via different pathways.

Personally, I use topical lightening creams, orals and different machine-driven therapies to target the pigment at different levels in the skin to get optimal results.  Treatment of melasma is like a regime and requires patience as multiple sessions are required.

Nonetheless, you should also have an examination done as not all pigmentation are melasma and different types of pigment will require different treatment modalities. Hope that helps.

All the best!

Melasma often presents as brown patches on both side of the cheeks, and is fairly common amongst Asian women and the darker skin types.

I can totally understand that patients can be quite disturbed by its appearance, especially if they cannot even conceal with makeup.

Melasma is one of the more challenging pigmentations to treat since the causes are a complex interplay of factors including age, genetic, hormonal, vascular, and sun exposure.

Having said so, there are available effective treatment options that include topical lightening creams, chemical peels, oral medications and pigmentation lasers. Sun protection measures are equally as important as well. Thus you may not even need lasers treatments.

In my years of practice treating many patients with various types of pigmentations and difficult melasma, I can say to you is that melasma can still be treated quite well with good results.

So Lizlee, I would recommend you to speak to an experienced doctor whom you are comfortable with to first verify on the type of pigmentation that you are having and the most suitable treatment options for you.

For more information on the treatments of melasma, you can read more about them in my "Ultimate Guide to Pigmentation Treatment in Singapore".


Hope this helps!

Cheers!

Dr David Ng C H

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