Chemical Peels vs Lasers - Which is better? | Dr Davin Lim

What is melasma?
Melasma is also known as hormonal pigmentation or cholasma. It presents as patchy pigmentation on the forehead, under the eyes & upper lip.
Melasma is caused by a combination of genes, UV rays, and hormones. It is more common in pregnancy & may occur after taking the birth control pill.Chemical peels are useful adjunctive treatments for melasma.
.
.
Peels can be tailored according to skin type, downtime & budget. Much like lasers, they are most useful for epidermal & mixed melasma. My favorite peeling agents for melasma include Dermamelan, lactic acid, retinoic acid & modified Jessner peels.
.
.
What peels are used for melasma?
Lots, but the safest peels are low strength glycolic, lactic, retinoic acid, modified Jessner & low concentration TCA. Novel peels including Dermamelan & Cosmelan can be useful.
.
.
Why do some Brisbane Skin clinics treat melasma with Fraxel?
Because Fraxel carrier more profit to the provider, as each treatment ranges from $890 to $1690 per session. I do use Fraxel for resistant melasma, however as first line therapy, I prefer precision Q Switch lasers as they are more effective, have less side effects & cost 1/5 that of Fraxel.
.
.
Pico is most useful in mixed pigment including melasma, sun spots, freckles & age warts. Pico is especially useful in darker skin types, including ethnic & Asian skin.

[@hilnlou]

I'm a long term skin cancer patient. I like the chemical peels better because they really get the Keratosis, and I get the one deep peel. It keeps the Keratosis under control, clears up my dark spots, and takes care of pre-cancerous lesions. I've tried laser a few times and I just don't get the same results as a good, strong chemical peel. I get one every 2 years and the recovery isn't bad at all. I mean you don't want to go out in public for about a week, but that's fine with me.

[@cucdo4833]

Can you tell me what is TCA mean?

[@hilnlou]

@@cucdo4833 it's "trichloroacetic acid peel."

[@marisamorais3150]

@hjjewels TCA isn’t an at home peeling! It needs a professional to do it

[@helenalovelock1030]

Which peel do you get please?

[@helenalovelock1030]

Which types do you get ? Once every 2 years ?

[@mimimoon6082]

Excellent video Dr. Lim! This is exactly the information I've been looking to get! I appreciate your knowledge and education in skin conditions, including melasma; and I appreciate YOU! Thank you so much! ❤

[@kjohnsonshelton0923]

Thank you for explaining the differences. Now I understand😊 I was a full freckled-face girl all my life until I got pico sure laser done at the age of 44 …about 98% of my freckles were removed!! I’d tried all sorts of lotions and potions for many years, but pico sure was the answer. I highly recommend!

[@hanhkelley369]

Hi. Did they give you the whitening cream such as ( Hydroquinone, Tranxenamic acid..) to use in the meantime with laser picosure? I have melasma and Hori naevus. I would love to treat my kin with laser picosure but i dont really know how effective it is.

[@kjohnsonshelton0923]

I did not use any creams afterwards, other than my usual skin regimen. I don’t know if picosure treats melisma, but it’s worth checking with your dermatologist. Good luck!

[@hanhkelley369]

@@kjohnsonshelton0923 Thank you for sharing! Best wishes for you.

[@suesuez8452]

Hi maam i also did lazer treatment but my malasma did not improve, it gets darker even with a little exposure in the sun that also after applying sunscreen.... It's this happening to u too?

[@hanhkelley369]

@@suesuez8452 What kind of laser did they use on you melasma? If they set the temperature too high, it would be more likely causing more hyperpigments. You should try topical cream such as Hydroquinone, Arbutin, Kojic acid.

[@1cyclerider4god]

Thank you for the excellent video. I’m getting ready to do something and have a consultation next Monday so this was very helpful. Much appreciated.

[@ozlembilliejean]

thank you for all those highly precious information. I love your informative videos ❤

[@ballhopper]

Thank you! This was a very educational video.

[@shz8990]

I had so many brown spot did my first jessner peel and it helped a lot I highly recommend peels..my skin is brown

[@mariamuniz3296]

Terrific breakdown! Thanks from the US

[@simonac688.]

Quick but great Doc 👍👍

[@sinajuningsihwirjawan4132]

I like your explanations. Could you share monthly routine treatment lasers and chemical peels? I mean: is laser's periode 6 month or how long? Thanks. Waiting your magical and educated explainations.

[@samblu9772]

Why is pico laser side effects 3-4x more than Q switch? I thought it’s safer as the pulse width is in Picoseconds as opposed to nanoseconds? Also, Q switched YAGs use NDYAG which has less selectivity for melanin compared to picosure pro which is alexandrite with high specificty for melanin. Please explain thanks

[@fweedomfighter6285]

Hey Dr. Lim, love your vids. Im curious if you would ever recommend doing a PRX peel right before a Pico session?

[@arlierliawati1291]

Thank you Dr Lim ❤️🙏

[@joanofarcxxi]

Doctor, please make a video on skin tags removal/treatment!!!!! Thank you so much for all the info. 💖💖💖💖💖

[@drpriyaratnerathod2773]

I am your big fan sir following you past 10 years ... currently i am in Netherlands europe was practicing in India ..

[@mjbrownlee7979]

Oh wow!! A dermatologist with tattoo sleeves😮 . 👌

[@kims4633]

Very interesting video!!!

[@paulitascott7626]

Pine bark extract supplements ( also called pycnogenol) help from the inside!!

[@birdlover7776]

@@varda94faiz97it’s an anti inflammatory supplement

[@J.E.C.]

they do nothing to melasma

[@mikromue]

Be careful everyone! Recent studies showed that lasers can lead to the increase of Granzyme B which is associated with fat loss and premature aging. This is why lasers look good for a while but often times it backfires (months/ years after that). Doctors often only see the results from days/ weeks after the treatment.

[@-nellie-m3711]

I haven’t watched your video as yet Dr, but I’d love to ask a question 🙋🏼‍♀️ whether “ELLACOR” treatment is available here in Australia 🇦🇺 and if so does your clinic offer this procedure, I’ve recently watched a couple of videos of it being done on women in the USA 🇺🇸 and it’s something I’d be interested in having done, I do hope you can get back to me on this question Please.

[@rationalatheist9824]

Same!!! It’s the new craze omg

[@theo610]

Phenols then TCA trumps all lasers

[@helenalovelock1030]

What are they … Peels ?

[@helenalovelock1030]

Peels more expensive than lasers ? That strange I thought they would be cheaper

[@RedPilledAsFuck]

@@helenalovelock1030they are cheaper

[@helenalovelock1030]

@@RedPilledAsFuck so if o were to look at peels what would be the best schedule routine ? Start at phenols ? Then TCA? Are phenols peels ??

[@neenee5198]

Hi Dr. Lim. How about the aerolase laser for PIH dermal pigmentation?

[@niranjanmulik2733]

Can you make some more videos about belafill?...and your viewers would really love to see some before and after photos

[@AngelwithAttitude7]

I had some belafill done under my eyes. It lasted three months. Not happy about that. My metabolism pushed it right out. Normally when I get my under eyes done it last almost a year, sometimes 8 months. L Last week I went to a different doctor and had a different filler. My eyes look better. Much happier. 😊

[@emmad4tennis695]

Love the info. In Australia, wondering to spend $300 for a dermatologist consult or go to one of those clinics that offer peels and lasers. But lot of places have technicians perform these procedures instead of doctors. Do most aussie dermatologists offer such procedures?

[@Zee.H]

May I ask which laser is better for scars (surgical/injuries) .. Pico or fractional?

[@hanhkelley369]

FRACTIONAL CO2.

[@Valero306]

Hi Doc!! I had the deepest ice pick scar on my cheek and 3 month ago a " dermatologic" applied TCA cross on my scars! The result was that now i have visible dark and red marks! It gonna be worst! Now i dont know! Can i send you fotos of the damage? Please! Id like get a virtual meeting

[@alpnakumar9555]

any thought about VI Peel brand for Hyperpigmation treatment?

[@miaperalta3095]

I had my Picosure and Picofocus for my melasma but it got worse.. became darker and it spread despite use of sunscreen😏

[@suesuez8452]

Same here how is ur skin now? Is it improving?

[@anungtarainyo6524]

Exactly mine after co2 laser 😢

[@rebeccaphillips2207]

If I have post inflammatory hyperpigmentation can it be treated the same way?

[@maxianoacosta]

you should do a video on phenol peel

[@helenalovelock1030]

Do you have a video on BBL Hero broadband light and or Halo ???

[@Tutume1111]

Dermatologist with tattoos ..I like that! 😁 BTW what would you recommend for acne marks and enlarged pores? Laser co2 or TCA? Would be great to hear some opinion on that

[@chrishnah]

I had RF microneedle and laser for acne scars and would not reccomend. It caused volume loss and fine lines and actually made some of the scars worse.

[@Tutume1111]

@chrishnah oh wow! Thank you!I'm sorry to hear that ...do you find chemical peels better then? I have started TCA sessions but early days so too early to say if it works really

[@megh2308]

Does anyone know if he's done a video about histamine response? I had PICO done and am so itchy!!

[@zinebboukerche3050]

okaay what's better for (scars and poores)..peel or laser?!!!!

[@astabee1]

Doc what’s the best thing to do for acne marks ?? ( I’ve tried Microneedling 3 times) my PIH & PIE is still the same & bothering me 😩😩 my doc recommended Microneedling

[@db-gb5xi]

He covered microneedling vs lasers about three weeks ago. I believe he said for bad acne scarring that lasers were better but check the video to be sure.

[@Rogvaiv7]

Chemical peels are best! Try first The ordinary 30% AHA BHA peel as it’s very affordable, then later on you can book an appointment for a stronger one.

[@mieko1221]

Chemical Peels,Lasers or topical treatment with Hydroquinone 4% used with Tretinoin.

[@marisamorais3150]

It depends. For PIE microneedling is better as it builds collagen but it needs to be used with some topical, or you can try PRP. For PIH in my opinion a chemical peel is better, but you should be at an at home antooxidant plus tirosinase inhibitors routine as you have IV phototype. I hope this comes helpful

[@rolaashour2576]

Dr. How do you feel about transexmic acid 1/100 topical

[@marisamorais3150]

You can determinate the depth of melasma by using wood lamp.

[@davidrosales4255]

Could you share the settings for q switch lasser??

[@saltandsugar]

Doc ,can melasma come back after q switch laser treatments ?

[@cv7958]

Yes, melasma has a habit of wanting to come back if the triggers aren’t removed (which is difficult since it typically involves birth control, UV/blue light, hormones, heat etc.). You have to maintain with strict sun protection, prescription topicals, in-office maintenance treatments (it’s not one and done).

[@TheAlvaroReis]

Is there any partner clinic in mainland China?

[@user-qt8ps5ii5d]

hello doctor i need a little help.. i did pyruvic acid and lactic acid mixed,,, i have hyperpigmentation is it good ?

[@lf9341]

What about Fraxel dual? I had melasma from HRT on my mustache area? I'm much better once I stopped HRT but want to improve skin tone.

[@tl9113]

Did you do the fraxel? Thinking about doing it for anti-aging i dont have pigmentation issue

[@blox_fruit_kings]

Hello Dr.Lim just want to ask if picosecond laser pen can work in birthmark too? Coz I purchased it already in online shop..Thanks

[@BroDoc9000]

You’ll need to update your HT doc, I can see light coming through the scalp pretty clearly. Add a very low strength oral loniten maybe 0.25 mg if you have no family history of heart problems. Also finasteride or dutasteride obviously; might as well go for the trifecta in gold standard treatment with capillus light therapy. If you’re not using an anti-androgen topical shampoo at least 3-4x a week like ketoconazole or my personal favorite regenpure… I can’t take you seriously on derm therapy. Good luck

[@kevinhanley6462]

👍

[@barbarabooth8419]

What about forever young bbl ?

[@papojaeger5483]

Which treatment is best for skin tightening? I have done Secret RF. I read morpheus8 or profound better option. I am olive skin, can‘t do laser.

[@Chanel15477]

Don't use morpheus 8 it's not worth the pain when there are other ways to microneedle that are effective.

[@yashfarohail]

My 2 years old daughter has light brown patch on her face under ear kindly suggest me something

[@AshleyDoll89]

Try vi precision plus peel with booster

[@J.E.C.]

you seriously consider doing lasers and peels on small child? 🤦🏻‍♀

[@CoolGobyFish]

Meleezmah))))) Come on man, it's melasma.

[@sarahkhan3835]

He an Aussie. That’s their natural accent.