A review of melasma treatment focusing on laser and light devices

Semin Cutan Med Surg. 2016 Dec;35(4):223-232. doi: 10.12788/j.sder.2016.060.


Melasma is a pigmentary disorder of unclear etiology with numerous treatment options and high recurrence rates. Laser and light therapies may be utilized cautiously as second- or third-line options for recalcitrant melasma, but low-energy settings are preferred due to the risk of postinflammatory hyperpigmentation and melasma stimulation. Commonly used lasers include the low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser, nonablative fractionated lasers, and intense pulsed light. Strict sun protection, concomitant use of bleaching agents, and maintenance treatments are necessary. A variety of other treatments that may also help to improve results are now being more widely adopted, including oral tranexamic acid, pulsed dye laser, antioxidants, and laser-assisted drug delivery.

Keywords: fractional lasers; intense pulsed light; laser; laser-assisted drug delivery; melasma; pulsed dye laser; q-switched; tranexamic acid.

Publication types

  • Review

MeSH terms

  • Humans
  • Laser Therapy*
  • Melanosis / therapy*
  • Phototherapy*