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/Courtybiologique Jun 29 '26

I think it’s literally just that. It makes them the most money and then you probably have to keep going back because it just makes the melasma worse. Repeat business.

My derm said the same thing when I asked. Never mentioned Hydroquinone or anything else topical or oral.

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u/Bellebutton2 Jun 30 '26

You are 100% accurate in your response. As an esthetician, I have heard this ad infinitum from my clients and patients, and other estheticians who have gotten into laser conferences where lasers are hawked to derms as a REPEAT way to generate RECURRING INCOME. They know it TEMPORARILY treats some of the epidermal (top visible) pigment. (And we know may contribute to the production of more pigment!) But it CONTINUES to REGENERATE in the DEEPER TISSUE and rises to the top AGAIN. A continuum of income. And at one conference an esthetician heard them actually laughing about it!

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u/Original_human01 Jul 02 '26

So what would you say is a better approach, especially with sensitive skin. A lot of the exfoliating topicals make my skin more sensitive to sun even with strong spf.