What should you know about laser CO2 for melasma?

Melasma causes brown or grey-brown patches, often on the cheeks, forehead, upper lip, or jaw. CO2 resurfacing deliberately creates controlled injury, which can stimulate pigment after inflammation. That response is more concerning when melasma is active or your skin has previously darkened after irritation. A clinician should confirm the diagnosis, look for contributing factors, and explain whether the possible texture benefit justifies the pigment risk. CO2 is not automatically the first choice for facial discolouration.

Discuss daily broad-spectrum sunscreen, shade, hats, heat exposure, hormonal factors, pregnancy or breastfeeding, and any current pigment medicines. The clinician may recommend stabilising melasma before considering a procedure. Depending on your skin and goals, options can include topical care, laser toning, a chemical peel, microneedling, or a skin brightening treatment. After any procedure, follow the exact cleansing and medication plan, avoid picking or scrubbing, and treat new irritation early.

Seek review for rapidly worsening dark patches, severe swelling, blistering, increasing pain, pus, fever, or redness that keeps spreading. Eye pain or vision changes after facial treatment need urgent assessment. Pigment often changes gradually, so do not add bleaching products or repeat a procedure without professional review when the colour is becoming more uneven.

Ask how the diagnosis was confirmed, why CO2 is being considered, what pigment-prevention plan will be used, and which alternatives fit your skin. Clarify the chance of temporary or persistent colour change, the recovery routine, sun and heat precautions, and the follow-up plan.