Is it true that laser treatment for melasma makes it darker the more you do it?

Today, the doctor will address a common concern: why do some cases experience darker melasma after laser treatment? This is a real possibility, but it doesn't mean laser treatment is bad. The key lies in three main factors. That's something we need to understand together.

Factor 1: Device and energy choice.

Not all lasers are the same. The reason why melasma may darken after treatment is partly due to... Using substandard tools, or selecting the wrong type of laser and energy level for the problem. Yes

The image shows an interesting research example, which I will use to make a simple comparison between two commonly used types of lasers:

• Pico laser, 532 nm mode (high energy): The doctor will give you a simple comparison. A 532 nm laser is like using an eraser that erases very strongly and cleanly on the top layer of the skin. Because it binds to pigments very well, it fades melasma quickly. But if you rub too hard (using high energy), the paper (our skin) will become thinner, abraded, and easily inflamed. The consequences are... The skin produces new pigment to repair itself, resulting in dark spots known as PIH (Post-Inflammatory Hyperpigmentation). It makes the blemishes appear darker.
• Pico laser, 1064 nm mode (low energy or low-fluence): part A 1064 nm laser is like using an eraser, gently erasing even the deepest layers. Yes, it might require several erasers to get it completely clean, but our paper (surface) won't be damaged or inflamed. Much safer and does not trigger the recurrence of dark spots. Yes

Therefore, choosing standardized equipment and selecting the correct laser mode by a qualified physician is most important.

Factor 2: Shooting Technique

"The laser isn't at fault, it's the settings that are wrong" is the most accurate statement. Even with the best equipment, if the doctor sets the energy level too high or fires repeatedly in the same spot unnecessarily, it's like unknowingly damaging the skin. Yes

Imagine this: if you shoot energy too forcefully, or repeatedly in the same spot, your skin will be damaged... "Accumulated heat" Beneath the skin, it's like a mild sunburn, but it happens from within. When the skin has chronic inflammation, the body instructs melanocytes (pigment-producing cells) to work harder to protect the skin. The end result is... Melasma that had faded has become darker than before. And additional post-inflammatory hyperpigmentation (PIH) may develop.

Factor 3: The patient's skin condition and post-treatment care.

The final, equally important factor is the patient themselves.

• Skin condition before treatment: Patients who have The skin barrier is weakened. Or, if there is already underlying inflammation under the skin, the risk is very high. Even laser treatment with low energy may trigger a flare-up of melasma.
• Post-procedure self-care: This is what doctors always emphasize to their patients! After laser treatment, our skin becomes especially delicate and sensitive to light. If patients do not take strict care of themselves, such as not applying sunscreen, neglecting to apply moisturizing cream to help the skin recover, or still engaging in outdoor activities that expose them to intense sunlight... The skin becomes very sensitive to light and prone to recurrent hyperpigmentation (PIH). This can lead to less effective treatment outcomes or even worse results.

Treating melasma doesn't rely solely on lasers.

Besides laser treatments, there's another treatment that's become a very popular and effective "supplementary" option: A program for injecting medication directly into the skin layer. Or, as many patients may be familiar with, by the name... 'Mesotherapy for melasma' (Meso-Melasma) Yes, this method will deliver important medications such as: Tranexamic Acid group or various skin vitamins. This treatment directly targets malfunctioning pigment-producing cells, inhibiting melanin production and reducing inflammation under the skin, which is one of the causes of darkened melasma. Doctors usually recommend this treatment. Do this in conjunction with laser treatment. To enhance the effectiveness of treatment and achieve clearer and faster results, this is considered a comprehensive approach to managing melasma.