Lasers for Melasma

Melasma is a chronic pigmentary condition with a multifactorial pathophysiology, involving melanin overproduction, photoaging, and hormonal factors, making treatment challenging. Lasers and light-based devices, including intense pulsed light, photobiomodulation, Q-Switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, nanosecond laser, picosecond laser, nonablative fractional laser and ablative fractional laser have shown promise results, yet no single modality offers a definitive solution. Combination therapies, including oral or topical agents and lasers, yield better results. Maintenance treatment is crucial to prevent recurrence. Despite advancements, laser treatments must be approached cautiously due to risks like postinflammatory hyperpigmentation, especially in darker skin types.