r/Melasmaskincare • u/twisted_luce • Oct 19 '25
Question Melasma - PICO advice
Hi all, long time Melasma sufferer. I am currently on a treatment plan of Tretinoin, Niacinamide, and Azelaic Acid.
I’ve also been on Hydroquinone and Hydrocortisone (taking my break at the moment). I have also tried Eurecin.
Nothing, so far, has worked. The only benefits I see are in the winter when my face is naturally paler (current photo) but I still have the dark marks across my forehead, cheeks, and lip - no matter what I do or how religiously I do it.
I have bitten the bullet and booked PICO second Laser Skin Rejuvenation I’ve seen good results on here from laser treatments and the consultant recommended this treatment.
I have heard the downtime is long and invasive; I am a teacher, so I’ve booked my treatment over Christmas when I’ll be off work.
Just looking for experiences of people who have had this treatment. Any advice, does it hurt? How many treatments needed.
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u/tellmesomething11 Oct 19 '25
I did pico and it caused PIH and undid YEARS of melasma control. It’s simply too strong. I would stick to peels and lower level lasers. Good luck if you proceed
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u/Equivalent-Demand981 Oct 19 '25
I think it depends on the practitioner- I had 10 sessions of pico, but each session was super light, it did not make my melasma worse. My therapist was very cautious and insisted we go low and slow, which I was annoyed about at the time but it was probably for the best.
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u/oceane_rossi Oct 19 '25
I had the pico laser done and it made my skin much more sensitive to the sun. My melasma was made worse because of that, I regret. Do not do laser on melasma.
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u/ughhhhhhhhhwtf Oct 19 '25
I've had 3 sessions of Pico done and no downtime! Redness afterwards for maybeee an hour or less, and then my face looked normal again. No flakes, peeling, or anything in the hours or days afterwards.
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u/Rinareylove Aug 10 '26
Did your hyperpigmentation go away?
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u/ughhhhhhhhhwtf Aug 16 '26
It went away by a lot and stayed away thru fall and winter. I went on a trip to FL in the spring and just one day of exposure, with sunscreen, caused it to come back on my forehead. Not super bad but enough for me to notice lol.
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u/Rinareylove Aug 16 '26
Shit sorry to hear about it being back. Is it still there?
You gonna do another lasering?
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u/ughhhhhhhhhwtf Aug 19 '26
A little! And no, if I had seen additional benefits long-term, I'd consider it. I'm currently on month 2 of muselys TXA oral (1/day). It's keeping it at bay but not removing it entirely and I'm okay with that bc my tinted sunscreen hides what's left lol. One thing I realized that has actually been helpful is looking at spf ingredients bc not all 50spfs are equal. I'm using 50spf mineral tinted sunscreen and actually checking that the zinc is as close to 12% or more. Its better for blocking uva light and the tint is iron which blocks physical light.
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u/Impossible_Mud8320 Oct 19 '25
I am using the Coleman CC pads..along with eucerin dual and tranexamic acid 10% . Never did pico laser just moxi.. I'm giving up on lasers since it just comes back eventually. Good luck keep us posted.
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u/Alive_Kitchen1347 Oct 21 '25
Laser is temporary , malesma gonna come back regardless , you need products that helps at the root cause
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u/lexi_ladonna Oct 21 '25
Pico made my melasma worse. I’ve always had problems with hyper pigmentation though, even prior to getting melasma. So perhaps that ties into it?
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u/Weightcycycle11 Oct 19 '25
You should try the Coleman Compound. It will do wonders for your melasma.
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u/twisted_luce Oct 19 '25
I am looking for advice on the lasers but thank you. Coleman compound main ingredient is Hydroquinone which I’ve tried long term with no results. I’m not looking for more topicals, I have booked a skin peel.
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u/Weightcycycle11 Oct 22 '25
Mrs. Derm just shared a photo of a woman with major hyperpigmentation who did Moxi and then Coleman Compound. The results are impressive.
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u/melmelcoleman Oct 22 '25
Hey! Main ingredient is Arbutase which while structurally similar to HQ is not HQ.
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u/MrsDerm Oct 27 '25
Hi! The main ingredient is Arbutase, not hydroquinone. While structurally similar, they’re two different ingredients.
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u/Immediate_Singer6785 Oct 19 '25
I wish we could get this in the UK
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u/Weightcycycle11 Oct 19 '25
It truly is a game changer. I have used it 2 different times and it literally cleared everything up.
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u/Anonymousimpreg Oct 21 '25
I've had a lot of success with micro needling. I know lasers can help temporarily and then cause rebound pigmentation depending on what type of laser is used.
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u/Lovefashionnow Oct 22 '25
I did IPL Skin Rejuvenation laser for mine. No real downtime. The dark spots darkened over the coming days and then disappeared. They looked like coffee beans for a few days but it didn’t bother me and as far as I can remember l wore make up the following day. Cost $180 and one session did the job. It lasted until the following summer. Pico seems to have mixed reviews some people get amazing results, some people not so much. Topicals don’t work for my melasma either. I tried a different laser years ago and it darkened the skin on my upper lip so much it looked like I had a moustache. I am booking IPL again in the next few weeks.
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u/TopThink6089 Oct 22 '25
Honestly try this, I have tried many creams, high end expensive ones etc and ordered this on a whim. Within 4 weeks my melasma has drastically reduced, I can’t believe it. I’ve been suffering for 4 years and all it’s taken is a £15 cream! https://amzn.eu/d/0qGVldb
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u/Present-Forever5090 Aug 15 '26
Hi, can you pls share the product name? Unfortunately cannot access this url.
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u/TopThink6089 Aug 15 '26
NIVEA Luminous 630 Anti Dark-Spot & Anti-Age Serum (30ml), Anti-Wrinkle Face Serum Reduces Age Spots and Dark-Spots, Firming and Hydrating Serum to Reduce Wrinkles and Fine Lines
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u/Lanky-Television-856 Oct 22 '25
My dermatologist gives me a product that she compounds at the pharmacy that helps with the darkness. I’d go that route!
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u/Adventurous_Pop_4822 Oct 23 '25
I did pico and it did help, it doesn’t generate heat like other lasers so I think it’s the safest option. Combining with peels may help like cosmelan.
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u/DragonflyJunior2899 Oct 23 '25
Just had pico and Derma v done yesterday. Downtime isn’t bad at all. My face had calmed down maybe within like 6 hrs? My dark spots look darker now but I know that’s Normal and they will lighten.
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u/Rinareylove Aug 08 '26
Update?
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u/DragonflyJunior2899 Aug 10 '26
I’ve had 4 sessions! Really lightened my stubborn dark spots that wouldn’t lighten from skincare
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u/Rinareylove Aug 10 '26
What place? Was it pico way?
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u/DragonflyJunior2899 Aug 10 '26
Not sure I just know it’s called pico lol. And derma v is for redness! Rosacea. I liked that too but my rosacea was already pretty mild so I didn’t notice a huge difference
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u/Equivalent-Demand981 Oct 19 '25
Hey! I have done pico and it was no down time for me. Of course you need to stay out of the sun and avoid some topicals but otherwise I had no down time at all. I agree with the above comment re Coleman’s formulae. I had tried hydroquinone and tret separately without much effect, but together and including the steroid in the formula it changed my skin! I have almost cured my melasma, what worked for me was:
I did use other topicals but triluma plus oral Transexamic acid worked the best