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Philip Young, MD answers: Best treatment for olive skin with age spots, sun spots, melasma?

I'm 47, light olive complexion w/ pinkish undertones, brown eyes and dark brown hair; was very active in sports from age 7 through 20's-prior to the emphasis on the importance of sunscreen & sun damage to exposed skin.

After 1 year of 4% hydroq., 0.4 retin A., and 4 IPL Tx's, no significant improvement is noted. The treating dermatologist of IPL(Nashville) states that my tx options are limited, states it's hormone related. Not much available for my skin type/color. A plastic surgeon (Chattanooga) advises against CO2 resurfacing.

Continued HQ and Rentin A have no significant impact. Have you successfully treated cases similar to mine with Fraxel repair?


Philip Young, MD
5 months ago
By Philip Young, MD - Seattle Facial Plastic Surgeon

Age spots and melasma can be treated althought it is a difficult thing to treat. IPL's, and all types of resurfacing can improve the appearance of these conditions. IPL treatment can affect deeper pigment. Sometimes the cooling will protect the more superficial pigment and hence this can stay within the  skin and also prevent penetration of other lasers. 

Sometimes you need to combine very superficial peels or resurfacing to the mix to improve more superficial pigmentation. Very light co2 resurfacing can also be used to decrease the more superficial pigmentation. Also, light peels and even microdermabrasion can help your skin pigmentation by allowing the topicals you are using to penetrate deeper into the skin to affect the cells that are dispensing the pigment into the surrounding skin cells. I would also add a topical steroid to the mix of your other topicals. Stronger topicals can also be used as well to help the situation.

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