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Laser Treatments for Melasma: What to Expect

Melasma

Melasma is a common skin condition that leads to the development of dark patches on the skin, primarily on the face. It is believed to be a disorder of photoaging, in which chronic sun exposure plays a major role. Other contributing factors include hormonal factors and genetic predisposition. One of the most promising treatments for this condition is laser therapy. But what can you expect from a melasma laser treatment? This article breaks down everything you need to know, from the types of lasers used to what happens during and after the procedure.

What Is Melasma?

Before diving into the specifics of laser treatment, it’s important to understand melasma itself. This skin condition leads to uneven skin tone, where dark patches, also known as melasma patches, appear most commonly on the forehead, cheeks, and upper lip. Melasma isn’t just about pigmentation; it also affects skin texture, contributing to a dull and uneven complexion. The condition is linked to melanin production, the pigment responsible for skin colour. Factors like sun exposure, hormonal factors (such as pregnancy or birth control pills), and genetics all contribute to the appearance of melasma lesions.

Melasma is classified into different types based on the depth of the pigmentation: epidermal melasma affects the outer layer of the skin, while dermal melasma goes deeper. This distinction is important because different types of melasma respond differently to treatments. Knowing your skin type and melasma classification is crucial for choosing the right melasma treatment, especially when considering laser options. Some treatments work best for lighter skin tones, while others are specifically designed for darker skin tones.

Why Choose Laser for Melasma?

While there’s no permanent cure for melasma, laser therapy has emerged as an effective treatment option for managing and reducing the appearance of melasma. Lasers work by targeting the melanin pigment in the skin, breaking it down and encouraging your body to naturally remove it. Over time, this leads to a significant reduction in the darkness of melasma patches. Patients often turn to lasers after trying topical treatments like hydroquinone, tranexamic acid or azelaic acid, which can take longer to show results.

Lasers are particularly useful for treating age spots, facial pigmentation, and pigmented lesions that can be difficult to manage with other treatments. Laser treatment has become an important facet of melasma treatment due to its ability to deliver faster, more visible results compared to traditional methods like creams, while avoiding the potential side effects of oral medications. 

Moreover, laser therapy can target larger areas of skin. However, it’s important to understand that laser treatments require post-procedure care to avoid making the melasma worse. Consistent use of sunscreen is non-negotiable after treatment.

Types of Lasers Used for Melasma Treatment

Types of Lasers Used for Melasma Treatment

There are several types of lasers used for melasma treatment, each with its own advantages and specific uses. Your dermatologist will select the most appropriate laser based on factors like your skin type, the depth of the melasma lesions, and how your skin responds to other treatments. Let’s look at some of the most commonly used lasers for treating melasma:

  • Fractional Non-Ablative Lasers (e.g 1927 Thulium Laser - MOXI) : These lasers target small sections of skin, allowing for faster recovery times and fewer side effects. They are often used in treatment sessions to reduce the pigmentation caused by melasma and are effective for evening out the skin tone and brightening one’s complexion.  This laser is ideal for individuals looking for minimal downtime, as it only affects a fraction of the skin at a time.
  • Picosecond Lasers: Known for their precision, these lasers break down the pigment without damaging the surrounding skin. They are highly effective for treating melasma lesions. Picosecond lasers work in ultra-short bursts, making them a popular and gentler option for patients with melasma.
  • Q-Switched Lasers: These lasers work by delivering short bursts of energy that target melanin production. This type of laser is effective in reducing the pigmentation of melasma patches and is particularly useful for patients with darker skin tones. The energy pulses help fragment the melanin particles, which are then cleared away by the body’s natural processes.
  • Radiofrequency microneedling (Sylfirm X): This treatment helps to strengthen the basement membrane, which is weaker in melasma. It also helps to improve vascularity issues associated with melasma. 

The choice of laser depends on various factors, including your skin type and the depth of the melasma lesions. 

The Laser Treatment Process

Laser Treatment

Before the melasma laser treatment begins, a thorough consultation with your dermatologist is necessary. During this consultation, your skin will be assessed, and the type of laser best suited for your skin conditions will be chosen. You may also need to use skin-prepping agents like tranexamic acid, hydroquinone, resorcinol or azelaic acid to improve the treatment’s effectiveness. Preparing the skin beforehand can enhance the results and reduce the risk of side effects.

Here’s what happens during a typical treatment session:

  1. Preparation: Your face will be cleaned, and a numbing cream will be applied for 30 minutes prior. 
  2. Laser Application: Protective goggles will be placed over your eyes to protect them from the laser light. Zimmer cooling will be used to minimize discomfort during the procedure and to optimize safety. The laser will be directed at the melasma patches, where it will target the melanin pigment in the skin. The laser works by breaking down this pigment, which will then be absorbed and eliminated by the body’s natural processes. The sensation can feel like tiny pricks on the skin, but the procedure is generally well-tolerated by most patients.
  3. Post-Treatment Care: After the laser procedure, your skin may feel warm, and you might notice some redness. In some cases, white spots or crusting can appear, which is part of the healing process. You will be given instructions on how to care for your skin, which will include minimizing sun exposure and applying sunscreen to prevent making the melasma worse. Post-treatment care is essential to avoid complications and maintain the results.

How Many Sessions Will You Need?

The number of treatment sessions required depends on various factors, such as the severity of your melasma and how your skin responds to the treatment. On average, patients need between three and five treatment sessions spaced a few weeks apart for optimal results. Each session lasts about 30 minutes. However, for more stubborn cases or deeper pigmentation, additional sessions may be required to achieve the desired outcome.

Consistency is key in melasma treatment. While the results are visible after a few sessions, maintenance treatments might be necessary to keep the pigmentation from returning. Melasma is a chronic condition, and without proper care, it can reappear over time, especially with prolonged UV exposure.

Are There Any Risks?

While laser therapy is generally safe, it’s essential to be aware of potential side effects, especially for those with darker skin tones. Individuals with darker skin types may be more prone to developing white spots or hyperpigmentation after treatment. This is why choosing the right type of laser and having an experienced professional adjust the laser settings is critical. 

Other possible side effects include mild redness, swelling, or peeling, which typically fade within a few days. To reduce the risk of side effects, it’s important to follow all aftercare instructions provided by your dermatologist. 

Complementary Treatments for Melasma

Laser treatments are effective but are often more successful when combined with other therapies. These may include:

Complementary Treatments for Melasma
  • Topical treatments like azelaic acid, resorcinol, hydroquinone or tranexamic acid to reduce pigmentation. These creams work by inhibiting melanin production, preventing the formation of new dark spots.
  • Oral medications such as tranexamic acid may also be prescribed to manage unstable melasma. Hormonal factors like pregnancy or the use of birth control pills can contribute to the development of melasma, so addressing these triggers can enhance the results of laser treatment.
  • Regular and appropriate use of broad spectrum, tinted sunscreen with a high SPF and protection against UVA and visible light is essential. UV exposure is one of the leading causes of melasma worsening after treatment.
  • Lifestyle changes include avoiding excessive sun exposure and wearing protective clothing. Simple actions like wearing a hat or seeking shade during peak sunlight hours can prevent melasma from worsening.

Final Thoughts

Laser treatments offer a promising solution for those struggling with melasma lesions, especially when traditional treatments have failed. By targeting the melanin production responsible for dark spots, lasers provide an effective treatment to help improve the appearance of melasma. Combining laser therapy with other treatments, such as topical creams and oral medications, can further enhance the results.

If you're considering laser therapy as a melasma treatment, consult a dermatologist to discuss the best options for your skin type and melasma severity. With proper care and a tailored treatment plan, you can achieve a smoother, more even skin tone.

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