Our specialists at Cutis Dermatology in Brisbane can efficiently improve pigmentation with pigment correctors, lasers & clinical chemical peels. Our melasma success rate is over 90%, with results seen as early as one week.
Our results speak for themselves
Pico laser for melasma. Picoway was used to treat resistant melasma in conjunction with medical therapy.
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Laser & tyrosinase inhibitors
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Why do we have the highest success rate of treating melasma?
At Cutis Dermatology we tailor treatments according to the clinical features of melasma- that is why our success rate is over 85%. Knowing the depth of pigment will enable us to target melasma with precision. Pigment can be superficial, deep or mixed. Deep melasma responds better to lasers, whilst chemical peels target more superficial melasma.
Cutis Dermatology has the widest range of pigment lasers in the Southern Hemisphere, including state of the art pico & nano lasers. Lasers offer a much safer, faster & more cost-effective treatment for melasma. They work by reducing pigment production using gentle laser light, whilst simultaneously improving skin quality by stimulating collagen.
Did you know that up to 50% of pigmentation can be faded with the proper use of sunscreen?
Melasma is exquisitely sun sensitive, however with a SPF 50 + sunscreen applied twice a day you will notice some gains within 2 weeks. From there, you can add pigmentation correctors, gentle chemical peels & lasers. We recommend La Roche Anthelios, Invisible Zinc & the Cancer Council range of sunscreens.
The correct mix of pigment inhibitors is key to effectively treating melasma. We custom-select ingredients & concentrations to your melasma type & your skin’s sensitivity level. A blended solution of ingredients includes ascorbic acid, citric, lactic, glycolic & retinoic acids along with niacinamide, arbutin, liquorice root extract & kojic acid. For superficial pigment, we add chemical exfoliators to increase the turnover of cells.
Melasma is one of the most common causes of pigmentation. Our specialists at Cutis Dermatology can efficiently improve pigmentation with pigment correctors, lasers & clinical chemical peels. Our melasma success rate is over 90%, with results seen as early as one week.
Our dermatologists & nurses have been involved in the treatment of melasma for 20 years. We formulate a customised treatment plan based on the depth of pigmentation, your goals, skin type & skin sensitivity of our patients.
The result of a professionally formulated treatment plan that is geared to leave the treated skin looking fresh, glowing, & evenly toned. You can be confident that our clinical team of nurses & dermatologists will tailor each plan to deliver outstanding results.
We spend time getting to know your pattern of melasma & understanding your flare factors. From there we can modify key aspects to reduce UV exposure. Importantly, each treatment plan is prescribed according to your skin’s sensitivity.
With careful examination we will understand the depth of your pigment. Laser settings & peel concentrations are dialled in accordingly. A customized approach gives the best results.
Most cases respond to specific lasers better than peels. We use pigment dedicated lasers in bespoke settings based upon the depth of pigmentation.
If you have superficial melasma, chemical peels can give an accelerated clearance. Your clinician will discuss options with you.
Learn more (link to melasma peels in this section)
We have 2 pico devices, the Picoway & Picosure Pro. Pico is used for mandibular melasma, dermal pigmentation & resistant melasma. Overall, we find that using lower-powered devices gives better results than high-powered lasers.
We see more cases of melasma rebound from microneedling than any other melasma treatment. Home micro needling with 0.1 mm needles can potentially increase the absorption of pigment correctors, however this treatment has been commercialized by skin clinics that use much deeper needles. Deeper is not better in the context of melasma.
In summary, don’t treat melasma with needles. Micro needling ruptures the basement membrane of skin, pushing superficial pigment into the deeper dermal layers.
The two devices that are culprits for melasma flares are-
- IPL or intense pulse light.
- Fractional lasers including Fraxel
Fractional lasers are only useful as last line treatment for super deep dermal melasma. They work by exfoliation of deeper pigment & should never be used as first line therapy, even for increased topical delivery.
Learn more (Link to Melasma Lasers )
Melasma is also termed the mask of pregnancy. It flares up with hormonal drive during pregnancy. Safe treatment during this time includes-
- AHA peels including glycolic & lactic acid
- L-ascorbic acid 10-20%
- Azelaic acid 10-20%
- Niacinamide 5-10%
Most cases will settle post-partum. At this stage other pigment inhibitors can be used, as can laser therapy.
2 types, a daily & one for activity. Look for SPF 50 +. Our recommendations are-
- Daily: La Roche Posay range, Invisible Zinc, Melan 130
- Outdoor: Sunsense range, Cancer Council, Neutrogena, Banana Boat
The recommended minimum application is twice a day for ‘daily use’ & every 2 hours for sport. One 50 to 60 ml container should last you less than 3 weeks. The biggest win you will get out of your melasma treatment is with proper use of sunscreen.
Learn more (link to melasma skin care in this section)
Here are some quick facts.
- Melasma pigment is stimulated by UVB, UVA, visible light & IR heat
- Windows protect against UVB, occasionally UVA, but not other wavelengths
- Tinting reduces UVA & attenuates visible light
- If you are sitting next to an untinted window, your melasma may potentially get worse
So, sunscreen is important, especially if the window is untinted.
Fraxel is an awesome laser for sun & age induced pigmentation, it is not a good laser for melasma as it generates too much epidermal heating. The two exceptions are-
- Assisted delivery of topicals when all else fails. We use very low power to deliver cosmeceuticals into the epidermis.
- Dermal melasma when all else fails. We use the old 1550 wavelength to promote trans-epidermal skin shedding of pigmentation.
Learn more (Link to Melasma Lasers )
Yes, for those who have prominent vessels we do incorporate vascular lasers to reduce the redness associated with melasma. This is less important than addressing other factors such as pigment production & reducing flare factors.
Dermal melasma is notoriously difficult to treat, this is because the pigment producing cells are deeper in the skin. This form of melasma can be treated with pico lasers & non-ablative devices like 1550 Fraxel.
Rebound melasma due to microneedling is another hard one to treat. This is because microneedles rupture the membrane holding the pigment cells together, pushing them deeper into the skin. If you are planning to microneedle, make sure the depth is not deeper than 0.1-0.2 mm.
The biggest traction you will achieve is with absolute sun protection. This entails learning how to best reduce UV exposure. Start with good sunscreen habits & understanding the times of the day that you may be unprotected (often in the afternoon, coming home from work).
Remember, if you are in a car, UVA & visible light goes through the untinted front windshield. This is the number one source of incidental radiation. By understanding & correcting this rate liming factor, pigment is much easier to manage.
From there you can follow as simple DIY guide to pigment-
AM: Salicylic acid wash 2%, Antioxidants ascorbic, ferulic acids, tocopherol. SPF
PM: Simple wash, azelaic acid, alternating with L-ascorbic acid 10-20% as tolerated
Formulations matter, be guided by your skincare expert. If you would like to know more about how to treat pigment, arrange a FREE* nurse consultation at our Brisbane clinics.