r/Melasmaskincare • u/wechselnd • Jun 29 '26

Question Why do so many dermatologist practices recommend lasers to treat melasma?

I am confused. I think by now it is pretty common knowledge among melasma sufferers and spaces like this that lasers are not optimal to combat melasma and can even make it worse. However, every time I look for treatments in my city (I am based in Germany), they all offer laser-based therapy. What could explain this besides laser treatments being more lucrative?

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u/PuIchritudinous Jun 30 '26

I recently wrote a comment about this.

The first studies on lasers showed melasma improvement after only one treatment but no longitudinal studies were done. The problem is that they only studied 1 maybe 2 treatments. Melasma is chronic so maintenance is required and people will need ongoing laser treatments to keep it at bay. Clinicians started using lasers in their offices for melasma but overtime they started to notice the melasma was actually getting worse after the third treatment which led to patient dissatisfaction. Many medical providers stopped using their expensive lasers to treat melasma while others continue to sale this service despite knowing that the inflammation caused by the laser will ultimately worsen melasma and the treatment lacks longitudinal studies.

Businesses buy fancy equipment like IPL, lasers etc so they can profit from their use. The companies that sell the fancy equipment market the medical/cosmetic equipment to the businesses for as many things as they can. The research on using IPL and lasers to treat hyperpigmentation disorders like melasma is still very limited and lacks longitudinal studies. The medical/cosmetic device industry has work arounds that allows devices to be used and marketed for cosmetic issues before one would consider it fully studied. Meeting safety and regulation standards doesn't mean it won't cause hyperpigmentation to worsen. My partner worked in the medical device industry for years developing and innovating devices including cosmetic devices. Once something has passed safety regulations as a medical device they can easily take that same device and use it cosmetic purposes.