In a world where the standard of beauty has been set at having clear and flawless skin, no wonder many people desire having these physical attributes to feel more attractive and confident. However, for some, the goal is a far reach from their current status, especially for those with conditions that require an ample amount of effort and time to resolve completely. This is true especially for cases of hyperpigmentation on the skin, like melasma. Fortunately, modern science and its innovations have given us options for combatting and treating these conditions. From topicals to oral treatments, the options are wide-ranging to accommodate specific needs of people. Laser treatments have also been gaining popularity in recent years. It is objectively a great option due to faster results and lower downtimes. However, its comparably higher cost and skepticism from the public limits its accessibility to many. And one of the many questions that still echoes through people: does laser treatment for melasma really work?

What does melasma look like?

Melasma is a hyperpigmentary disorder that appears as dark brown or grayish spots on the skin and causes social and/or emotional stress for individuals who are experiencing it. The reason why most patients are eager to treat this condition is because it mostly affects parts of the body that are not covered, such as the face, cheeks, upper lip, forehead, and chin. Less commonly, melasma can also develop on the arms, shoulders, and neck.

Who gets melasma?

Melasma is a common skin disorder, and while most people can get it, pregnant women are more at risk of developing melasma. This is because of the hormonal changes (increase in estrogen and progesterone) that occur during pregnancy, and it is also the main reason why melasma is sometimes referred to as the “mask of pregnancy.” Aside from pregnant women, most women aged 20 to 40 are also at risk of developing melasma compared to men. This can also be the case for most individuals (especially women) who have a medium or darker skin tone than those with lighter skin, or if you have any family history of melasma.

Triggers

Unfortunately, the exact cause of melasma still remains elusive. However, studies have given light to its mechanism and pathophysiology. Researchers have found that individuals who are experiencing melasma tend to have more active melanocytes, the cells that are responsible for giving the skin its color. Some researchers suggest that there are possible triggers for melasma, including but not limited to:

Sunlight: In response to being exposed to the sun, the skin produces melanin as a form of protection. It is believed that this is responsible as to why melasma seems to develop in areas that get exposed to the sun more frequently. Moreover, the ultraviolet and radiation from the sun can make hyperpigmentation and melasma worse.

Medications: In individuals taking certain medications like anti-seizure medications, birth control pills, or oral contraceptive pills, melasma seems to flare up or be triggered.

Phototoxic Drugs: These types of drugs make the skin more sensitive to sunlight. Phototoxic drugs usually include some antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDS), diuretics, retinoids, hypoglycemics, antipsychotics, etc.

Are there types of melasma?

Similar to other conditions, melasma is classified into different types, and these classifications are dependent on the depth of the pigment. The three types of melasma are:

Epidermal: Melasma that is dark brown in color, has well-defined borders and is at the more superficial layer of the skin. This type of melasma also responds well to treatments.

Dermal: A melasma type that is seated deeper in the skin.

Mixed melasma: This is the most common type of melasma among the three and often displays combined features of the epidermal and dermal types.

Are laser treatments effective?

The real question from anyone out there experiencing the effects of melasma is this: does laser treatment for melasma really work? The short answer is yes; research has shown that there are several types of laser treatment that are effective in treating melasma.

PicoSure: This is an effective laser treatment option for treating and fading melasma. It uses pulses of energy instead of heat, that quickly target the source. It works by breaking apart the pigment so that the body can naturally dispose of it. PicoSure is a quick and non-surgical treatment that is safe and has low downtime. Studies have shown that PicoSure is effective without any reported side effects.

Fractional Laser Resurfacing: This treatment uses a heat beam that specifically targets small sections of the skin to produce new cells that will cover the treated areas. It is also a safe and painless option for effectively treating melasma that results in a smoother skin surface with little to no scarring.

IPL (Intense Pulse Light Laser): This treatment uses a broad spectrum of lights in different wavelengths that generate heat to target and remove the discoloration on the skin. Because this treatment involves heat, it can spread to surrounding areas and develop into a known condition called post-inflammatory hyperpigmentation that causes darker spots to appear, so it is important to consult a dermatologist if the treatment is the best one for your needs.

Q-Switch: This treatment uses high-intensity pulse lights that pass through the top layers into the skin and into the hyperpigmentation which causes them to break into smaller pieces which will then be flushed by the body’s immune system. This treatment is the safest bet for anyone experiencing epidermal and dermal melasma types.

Laser treatments are generally an effective way for individuals who are looking into treating melasma when other methods have not responded well. Although some laser treatments may require follow up treatments to ensure that melasma does not recur. It is also important to note that after the procedure, the skin may feel more sensitive, and itching, burning, or stinging sensations may also be present. The treated areas may look reddish and discolored, so proper protection from the sun is essential, as is ensuring that the aftercare procedure is followed.