Hi Dr. N…
I suffer from melasma. I recently had laser to remove some pigmentation under my eye. It seems to be worse, red and brown. It has lighten up a bit. I am using Tri-luma. I just wonder if laser did not work is there no hope for me. Also, if I do consider a light peel how long after the laser should I attempt this procedure….
There is hope for Melasma. Its a chronic condition in many and requires a long term committment on your part as there are no quick fixes but there is hope.
What I dont know is what kind of laser you use and your skin color and ethnicity. The lighter you are and if you are caucasian then you have much more choices and options than if you are olive toned or middle eastern or Hispanic or Black or Asian. But all races do have options.
The cornerstone of therapy is daily at home use of Retin-A and Hydroquinone for months to years. It is not something you can expect to fix in just a few weeks. Quick fixes often end up worse. Tri-Luma has Retin-A and Hydroquinone in it but it also has a steroid which limits its use to only 8 weeks at a time. Steroids used more than that can thin out the skin and have other problems.
Depending on your skin color and ethnicity, there are various peels and lasers and IPL (photo therapy) options available but you cannot rely on these treatments if you are not on Retin-A and Hydroquinone.
You obviously cannot use Retin-A or Hydroquinone if you are allergic to either or if you are pregnant, planning on getting pregnant or breast feeding (sorry for sounding like a TV drug commercial).
There are hundreds of “lasers” out there. Some are good. Most are not.
If you send me a photo I may be able to give you more specific information.