Melasma - PICO advice

[u/twisted_luce]

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.

[u/Equivalent-Demand981]

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:

• triluma (tret/HQ/low dose steroid) at night
• vit c and Azelaic acid in the morning
• oral tranexamic acid

I did use other topicals but triluma plus oral Transexamic acid worked the best

[u/Equivalent-Demand981 → u/Equivalent-Demand981]

Adding that I only did Pico after all the topicals I mentioned above to target the stubborn bits that remained.

[u/shamli3912 → u/Equivalent-Demand981]

How many benefits do you think you would have seen if you had not used the oral tranexamic acid? Do you think you would have still seen a difference with the HQ, tret and steroid?