I've been researching Co2 laser for several years and have always wanted to get it but didn't have the one to two week period available for downtime. Now with pandemic, I had that time so I opted to go for it with dr. Joseph Cerni. He's been my to go to dr. for injectables for over 10 years and I've always received excellent results. I'm glad I did it, my skin feels tighter , brighter and smoother. There is an improvement with lines and facial scars but next time I would like to go deeper for even more improvement.
Dysport and Botox are both derived from botulinum toxin and are used to treat lines and wrinkles created from muscle movement. Both last 3-4 months for most patients. Dysport has a faster onset of action. For someone with an event in a couple of days that want a faster result, I would chose Dysport. Dysport units are different than Botox units. You have to use 2.5-3 times more Dysport to equate to 1 Botox unit. Most offices price Dysport at a lower price per unit, so to treat the area with Dysport or Botox should be similar price-wise.
Fractora is a great treatment for under the eyes. I typically use the 60 tip in this area, which is great for superficial lines. As others have stated, a series of treatments is recommended (usually 3 treatments-but depends on severity of lines) and it is best to continue Botox, creams, and other modalities to keep that area looking its best.
There are many options for laser hair removal. We have been using Diolaze by InMode, which is a diode laser. It is a very fast treatment, safe for most skin tones, and I have seen excellent patient results. Like all laser types for hair removal, it will take a series of treatments to have adequate reduction.
Botox works on the underlying muscles, while Retin-A works in the dermis so they can be used together to soften wrinkles. You can continue using Retin-A nightly. Make sure to apply sun protection everyday, but especially when using a product like Retin-A the night before.
Melasma is a chronic condition that can be difficult to treat. Treatment usually consists of bleaching creams, such as the Tri-Luma that you mentioned and other treatments (lasers, peels) and lifestyle changes (sun-protective behaviors). It is important to remember that bleaching creams should be monitored by your provider as you should not be on them long-term and must transition off and back on again throughout your management of this condition. Aside from creams, there are some lasers and peels that can help to minimize the appearance of melasma, but the single greatest thing you can do to help prevent it from getting worse is practicing sun-protective behaviors. This means wearing high-quality sunscreen (and reapplying), wearing hats, and seeking shade. Inflammation, heat, and hormones also play a role in melasma, so remember activities that cause heat and inflammation (such as waxing, sitting in saunas) may make the pigment appear worse. Because of its chronic nature, it is easy to be discouraged, but by seeing a provider experienced in treating melasma, you can have a management plan that it easy to follow.