I had my fist treatment yesterday. Before the treatment: I watched several YouTube videos on the process and read personal stories on this site and may others. Consultation: I was told it would take 4-6 weeks for my skin to fully heal, wear tons of sun screen and to stay home for a few days after the treatment. Note that my consultation was in June and my procedure was in January. They do not recommend doing fraxel during warm months as it does not allow for proper healing. About the treatment: I had numbing cream in my face for almost two hours and the procedure took about 30 minutes. It was a bit painful but manageable with the exception of the upper lip. It was painful when she did a run on the upper lip! It was also painful as she reached the hairline as she did not apply sufficient numbing cream to that area. My face was hot and uncomfortable for about one hour after the procedure. Then I kept feeling a slight tingling sensation as though my face was being misted (hard to explain but not painful). My face was red and slightly swollen. Late in the day I noticed pin sized marks all over my gave that were dark (almost as thought it was dirt marks). I had a balm that was given to me by the nurse on my face as well as some sun screen. I had sure I slept facing up (on my back). My skin feels a bit like sandpaper. My husband came with me and said the nurse was extremely thorough and promise! (My eyes were covered during the procedure) Day 2: my skin is still the same but a lot tighter. It was easy to wash my face this morning and I have another layer of fresh balm on my face. I've noticed a bit of peeling on my chin. Day 3: started peeling on my chin and noticed small pimples on my chin, nose, upper lip and jaw line. Skin is not as tight. Day 4: way more pimples and itching! Peeling a bit more to include my forehead and jawline. Struggling to not pick or itch right now. I also started using a vitamin c serum. I tested a small area on my check this morning and then put it all over except my chin at night. The dark marks I mentioned earlier are still there (they're scabs where the laser poked a hole in the skin).
Unfortunately some laser centers use what they have available to do more procedures and make more money. IPL is not the standard technology to use for breaking up tattoo ink. It has a high chance to burn and scar. IPL is created and used primarily to break up melanin and remove some redness from broken capillaries. It is not for tattoo ink. Hair removal lasers are designed to heat up the hair to prevent the follicle from growing more hairs. It can also burn and scar the skin if used over a tattoo. I have seen photos of a person that needed a skin graft surgery after an accidental hair removal exposure to it. Q-Switched lasers are very expensive to purchase, so there are very few laser clinics that are able to offer this procedure. However, if a center has a VersaPulse C or a ConBio laser, that is the place to go. My advice is to stay away from clinics that use machines that are not designed for certain procedures. It's a red flag.
We use ReFirme at our office because it is effective and safe with no need for anesthesia. My patients actually think it feels good, most of the time and most patients are extremely happy after 5 treatments. Thermage works well too, but it is more expensive for the patient and is painful, requiring topical numbing cream. The other disadvantage of Thermage is that it is mono-polar electricity, requiring a grounding pad. There have been cases where the energy went too deep and melted the fatty layer under the skin, causing pitting. This is a rare side effect, but patients should know that it is a possibility. ReFirme is also a technology that uses radio frequency electricity, but it utilizes a bi-polar format, which controls the depth of the energy. This controlled depth reduces the chance of pitting, making it a safer treatment. ReFirme takes 3-5 treatments to do a noticeable job, wheras Thermage takes 1-3 treatments. You should weigh the cost vs. benefit before making your decision. I have no experience with the Accent procedure.
Moles can be lasered safely for hair removal. Sometimes the mole will get a bit darker after the treatment and might flake a bit, leaving the mole somewhat lighter than it was. However, the settings can be low enough to not fade the mole, but high enough to remove the hair. If the hair is blonde or gray, your best bet would be removal of the mole or electrolysis.
My experience with stubborn lentigos is that Q-Switched lasers work the best. I see you have not tried this option. Look in your area for laser centers that offer tattoo removal. Call these clinics and ask what technology they use for tattoos and brown spots. Most tattoo removal is done using Q-Switch technology such as a VersaPulse C laser, or ConBio Laser. Either of these two should be a better option than IPL, peels, or Retin A. I would recommend starting with QS532 if the lentigos are superficial, or QS755 if they are deeper lesions. Hydroquinone cream 4% might also help you, but takes months to work and usually just fades stubborn spots. Q-Switched technology often removes the lesions with one to three treatments.
Most of the time permanent cosmetic tattoo ink, such as lip liner, eyeliner, or skin colored ink will turn black, or a darker color when it is first lasered. This color lightens with subsequent treatments, but the very first treatment can cause anxiety and fear for the patient. It is impossible to tell you how many more treatments it will take to get rid of this dark color. Yes, I recommend you keep at it.
