name: joy
email: joy@hotmail.com

I wanna know how to treat melasma that called ochronosis ,which type of laser can get rid of this melasma and how many times to clear it. thank you

Dear Joy

Ochronosis is one of common side effect of long term high potency hydroquinone treatment . Clinically there is slate gray to browish discoloration of the face. Under microscope examination there is homogenous brownish material in the dermis. This may be denatured collagen or other proteins. This condition is
rather difficult to treat with medication. The best treatment is now by doing laser ablation with either Carbondioxide laser or Erbium :YAG laser. Laser will remove skin down to the dermis follow by regeneration of new healthy skin. There usually is post treatment hyperpigmentation which will eventually fade away. This condition is one of the strong reason why we should not use hydroquinone for long term treatment of melasma.

Niwat Polnikorn MD