Melasma dermabrasion

Topical treatments for melasma usually include tyrosinase inhibitors, with or without tretinoin or one of its precursors. Azelaic acid is also a viable treatment option. A corticosteroid can be combined with it to counter any potential active inflammation. Lasers, intense pulsed light (IPL), dermabrasion and microdermabrasion have also been suggested, but often cause post-inflammatory hyperpigmentation. TCA can be an excellent treatment for melasma it eliminates the melanin stored in the papillary dermis and epidermis (Figure 13.8). Mesotherapy has been recently reputed as an effective treatment of melasma. ... 

Melasma can either be treated with superficial or medium-depth peels. Though medium-depth peels can yield good results if done with utmost care, superficial peels are currently the preferred and most frequently performed peels. It is effective and safer to use for all skin phototypes (Fitzpatrick 1-6) but with precautionary measures and care for daiker skin [30, 125]. Intense pulsed light, laser resurfacing, and dermabrasion have essentially supplanted medium-depth and deep peels [9]. 

Dermabrasion abrades the skin down to the level of the upper or middermis. Though it may have achieved good results in one study in melasma patients, it has also been associated with an increased incidence of PIH and other more serious adverse skin changes [90]. 

Kunachak S, Leelaudomlipi P, Wongwaisayawm S (2001) Dermabrasion a curative treatment for melasma. Aesthetic PlastSuig25 114-117... 

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