When is picosecond laser treatment recommended for melasma?

Melasma can involve pigment at different skin depths, and heat or irritation may make facial pigmentation more noticeable. A dermatologist examines the pattern, considers medicines and hormonal or sun-related triggers, and checks whether another pigment condition is present. Laser is usually an add-on decision, not a substitute for daily broad-spectrum sunscreen, shade and a plan to calm active melasma.

Have your clinician review recent tanning, pregnancy or hormonal changes, sensitive-skin history, and products that sting. Follow the prescribed preparation and aftercare exactly; avoid picking or adding irritating exfoliants while the skin settles. Ask how many visits may be needed, what temporary darkening or lightening can look like, and how recurrence will be managed.

Arrange a review before laser if the patches are changing quickly, bleeding, crusting, itchy in one spot, or not typical of your previous melasma. Contact the treating clinic promptly for blistering, severe swelling, spreading redness, pus, or worsening pigmentation after treatment.

Ask whether the pigment is epidermal, dermal or mixed; whether laser is appropriate now; which preparation reduces irritation; and what maintenance plan protects against recurrence.