Sure can. Picosure is made for darker skin types, including Asian, Middle Eastern & ethnic skin. It is super safe, provided correct settings are utilized.

Treatment time ranges between 5 to 12 minutes, depending on the extent of pigmentation. We typically space treatments 3-6 weeks apart. 

*Combination QSL & Picosure treatments extend treatment time to 15 minutes.

My team & I employ over 11 different types of lasers to treat melasma, depending on your skin type (color), depth of melasma pigment, previous treatments you have attempted & how fast you want results.  

Spectra, Spectra Hollywood, C6, RevLite, Pastelle lasers. These lasers work by reducing pigment production over weeks to months. They are low risk, slower to work, however cost less than Picosure Pro. For patients who are after faster results, we often combine Picosure with these older tech lasers. 

Fraxel, Lase MD. These lasers are best used for treating non-melasma pigment, & should not be used as the primary treatment for melasma. They can be employed in a special setting to deliver skin ‘actives’ to reduce pigment. 

Clear & Brilliant Diode lasers. Best used after Picosure or Spectra as a maintenance laser. 

Hybrid lasers. 1570 & 1550 non-ablative lasers can be used for resistant deep dermal cases of melasma. They work by pushing pigment in the deeper layers of skin upwards- the melanin shuffle. 

VBeam Prima, Perfecta, DermaV lasers. These lasers are best used in conjunction with pigment lasers & work by reducing vascular input. Best combined with t.acid.

No, but they are very useful. The answer for treating this condition is a combination of  creams, sun protection, & oral agents to reduce cell signaling to the melanocyte or pigment cell. Dermatologists prescribe creams that contain-

• Arbutin: a naturally occurring pigment inhibitor. 
• Azelaic acid: an anti-inflammatory agent.
• Ascorbic acid: an antioxidant, also known as vitamin C.
• Kojic acid: an oldie but a goodie, 0.5 to 1.5%. 
• Glycolic acids: in low concentration. 
• Botanicals: such as bearberries.
• Hydroquinone: the best pigment inhibitor but used in caution. 

Yes & no, think of lasers as a pair of scissors for cutting hair. Just as long as it is sharp, the end results depend on your hairdresser. Having a good & reliable laser is essential. In the context of melasma treatment, peak operating power is not an important factor, but consistency of power is. It is more complex than that, see the section on ‘Davin’s viewpoint’ below for a full explanation.

80 to 90%. Higher success rates in primary melasma, epidermal pigment, patients who are good with sun protection. 

Lower success from microneedling melasma, dermal disease. I have zero chance of improving melasma if you are not good with sunscreens.

 Treatments start from $390 (nurse performed procedure). Add $150 for combined Picosure Pro & nano Spectra laser. 

My fees for Picosure Pro melasma laser is $890 per session, hence it is more cost effective if my nurses perform this procedure.

*Note Picosure for melasma is different from Picotoning. The latter requires 3-4 times the energy & passes. 

Book a consultation with my team at Cutis Dermatology, Brisbane. My colleagues & nurses are experienced in assessing patients with pigmentation. 

A virtual consultation with myself is possible, acknowledging limitations apply; especially when it comes to dermatologic examination of pigment depth. 

Lasers & peels such as Cosmelan & Dermamelan are adjunctive therapies to medical management of melasma. Medical therapy modulates pigment production, namely to reduce pigment cell activity. We achieve this with the use of tyrosinase inhibitors & vascular endothelial growth factor modulation.  

Medical therapy entails the use of HQ, ascorbic acid, kojic acid, arbutin, & botanicals as first line, whilst tranexamic acid orally is used as second line therapy, followed by lasers & peels. 

No. I personally love chemical peels, I use them daily, however in the context of melasma pigmentation, lasers are more precise, cost less, & are more effective. Occasionally I do use Dermamelan & Cosmelan peels in select patients. These peels can give fast results; however they have a higher rebound rate, cost more, & are associated with a recovery period of 1 to 2 weeks. 

In select patients, I do employ retinoic acid, TCA, lactic & glycolic acid in low concentrations as part of rotational therapies for melasma. 

No, I cannot, but chances are we can help most patients. Remission from melasma typically is 4 to 18+ months, depending on endogenous factors (your genetics) as well as exogenous factors, namely sun exposure.