FAQ’s – Melasma Treatment with IPL


Patients that should not be treated include:

– those who are sunburned or have irritated skin in the sites to be treated

– those who are exhibiting unidentified skin conditions in the sites to be treated

– those who have healed poorly after other types of laser treatments

– patients prone to skin discoloration

– patients who are taking photosensitizing medication, such as Accutane, should discontinue the medication 6 months before treatment

– patients who are taking topical Retin-A, patients should wait 2 weeks before treatment

– don’t apply laser energy to any raised lesions, aside from purely red ones i.e. angiomas; other lesions should first be checked by a dermatologist

Patients who are sunburned should wait until the burn subsides. Herpes Simplex Labialis (fever blisters) can be activated by laser treatment, especially on the upper lip, and patients with a tendency for fever blistering can be started on antiviral medication before treatment

Setting expectations:

Some patients may not respond as well as others. Melasma lesions tend to darken after the first or subsequent treatments. Key factors in terms of treatment response are whether there is a sufficient melanin in the affected area, the depth of the lesion, and other factors. Regardless of the treatment response, recurrence is common and can be caused by factors such as sun exposure, genetic disposition and hormones. It is important to understand that melasma, like eczema and psoriasis, is a chronic condition that can be controlled rather than cured.

How many treatment sessions are required?

This can vary depending on the size density of melanin and depth of the affected area. Typically melasma will lighten or dissapear completely after 1-2 treatments although in some cases more treatments may be necessary.

Do I need to use topical anesthesia? What about gels?

Yes. Anesthetics and cooling gels may be required. However, some buildup of heat will be experienced, especially using higher fluences.

Is it painful?

There is a mild sensation of heat that is very tolerable. A slight pinching feeling may occur when using higher fluences \

What causes melasma?

Melasma is a very common patchy brown, tan, or blue-gray facial skin discoloration, primarily seen on the upper cheeks, lip, forehead and chin of women 20-50 years of age. Uncontrolled sunlight exposure is considered the leading cause of melasma, especially in individuals with a genetic predisposition to this condition. Melasma is most common among pregnant women, called Chloasma, especially those of Latin and Asian descents. People with olive or darker skin, such as Hispanic, Asian, and Middle Eastern individuals, have higher incidences of melasma.

Is it permanent, or will melasma come back?

Melasma is typically characterized by having up and down periods where the symptoms heighten and lessen. While the laser light can help lighten or completely rid of the pigmentation factors such as sun exposure, hormones and your genetic disposition can play a role in a reoccurrence of the symptoms.

Can it be used on dark skin?

 Patients with skin types IV-VI should be treated very cautiously, especially in the facial region, as they pose a higher risk of having hyper and/or hypo-pigmentations.

Can it be used on raised pigmented spots?

A dermatologist should first check raised pigmented spots before starting any kind of treatment. If the dermatologist clears the patient for treatment you may proceed with administering treatments.

What happens after treatment?

Typically, melasma will slowly lighten over the course of the next few days to weeks as the pigmented area is slowly absorbed into the skin by your body’s natural healing process. In some cases, the pigment will darken before becoming lighter. In the event that any crusting or scabbing occurs, it is important to always keep the area moist as to reduce the risk of scarring.