Premature aging at 31, IPL laser not effective. Specifically, what can I do to slow down and reverse this rapid aging? (photo)

Question

I am 31 and recently had IPL laser twice for big pores, redness, and pregnancy melasma. In the past before having children, IPL worked great and I had great skin. Now, it seems to have made things worse. Where should I go from here? Now it seems my pores are so big, and big acne scars appearing as well as new fine lines on my upper lip (I'm not a smoker) and cheeks. I'm afraid to do another IPL laser.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Adam Scheiner, MD · Answer

Dear Austin Patient,Aging skin is due a multiple factors. One is intrinsic aging due to genetics but the bigger cause is sun exposure in the past. By protecting your skin daily with sun protection, you can slow down the appearance of aged skin.To reverse aged skin, certain skin care products containing Retin-A and Hydroquinones can be helpful.IPL or BBL is a 2nd line of treatment but the most dramatic improvement would occur by stimulating the skin to renew itsself. I use lasers to resurface the skin and although there is downtime for recovery, it can result in a large improvement in acne scars and wrinkles in the face ( including the upper lip).I'll include a link below for you.I hope this was helpful.

Jason Emer, MD · Answer

There are a few great options for improvement.  I find that a combination of lasers or RF help skin tone, sculptra for collagen building, and microneedling/prp and skin care help with skin rejuvenation. Fillers, microneedling/prp, subcision and lasers can help acne scarring, while fillers and/or botox can be used for fine lines and wrinkles. Kybella, Ultherapy and/or ThermiRF treatments (Venus Legacy) would be non-invasive options that would do well in combination for skin tightening.  See an expert. Best, Dr. Emer

Simon Ourian, MD · Answer

Based off your concerns, the Coolaser&trade; is your best option. It assists with various concerns from wrinkles/acne scars/melasma etc. A combination of Coolaser&trade; and Blue Light therapy might be suggested for you, to tackle down the melasma; combined they give the ultimate result. For the large acne scars, a combination of the Coolaser&trade; and dermal fillers would work for you. You'll find that the recommended treatments will leave your skin fully rejuvenated.

Grant Stevens, MD · Answer

Hi there, We would likely recommend some great skin care (including Retinol, hydroquinone, Vitamin C and lytera) to be used for 1 month, then doing 2 Halo treatments, approx 1 month apart. This help with melasma, pores, texture, anti-aging, brightening etc. Best, Dr. Grant Stevens

Susan Van Dyke, MD · Answer

I would highly recommend Clear and Brilliant treatments for pores, color (including melasma), texture, photo damage etc...  It is quick easy, inexpensive and with no downtime.  It is done every month or so depending on the issues.  Combining it with good physician grade skin care is vital.If acne scars are an issue then I would consider Fraxel treatments.  These are about 10 times the strength of Clear + Brilliant, have 4 days of redness and swelling and can be repeated for better results.Often we start with Fraxel and maintain with Clear and Brilliant.

Fadi Nukta, MD · Answer

Thank you for your question! Consulting with a skincare
specialist in your area will be a great start. Using the right skincare
products and maintaining a skincare regimen will help improve the skin’s
texture, pigmentation and elasticity. BBL/IPL is a great treatment for
anti-aging purposes, however; BBL/IPL needs to be performed regularly for the
best results, and keeping your skin protected from UVA/UVB by using a sunscreen
is a priority. Including an antioxidant in your regimen can really help improve
fine lines, wrinkles, pigmentations, increasing collagen and elastin in the
skin. And keeping your skin hydrated internally by drinking water, and
externally by applying the right moisturizer will help reduce and prevent
further fine lines and wrinkles.

Tarek M. Fakhouri, MD · Answer

Hi LA719,
Thanks for the great question! In evaluating your photos it appears you have oily skin type. This puts you at risk of acne, large pores, dilated oil glands, and post inflammatory hyperpigmentation (dark spots after acne bumps).
You mentioned that your skin changed with pregnancy. This is common due to the hormonal changes from pregnancy. If you are not pregnant or planning pregnancy again you could consider acne treatments first. Accutane or spironolactone might be great options for getting your skin back under control.
Once your acne has calmed down, I would suggest microneedling resurfacing. A series of treatments can produce excellent results for overall skin tone and texture. Resurfacing lasers can work well but you have to be careful since you have a history of melasma. If you go to an inexperienced doctor for a laser treatment it could backfire and produce more dark spots. Be sure to see a board certified dermatologist who has cosmetic experience and training in all skin types. Since you live in Austin you should begin treatments soon before it start to get very sunny outside and your risk of dark spots increases.
Hope this helps! You are the perfect candidate for these treatments!
-Tarek

Dennis Gross, MD · Answer

IPL is a great treatment, but it's not the right solution for everyone and sometimes as we age and change, treatments that once worked well no longer do. That being said there are a lot of potential factors at play here - I'm not sure if you went to the same doctor and had the same machine, what the settings were, etc. I would be very hesitant to agree that IPL would worsen your skin unless you were burned by the treatment and experienced hyperpigmentation. Based on your photos I could recommend a few things - I would advise a neuromodulator for forehead lines and a lightweight dermal filler for your nasolabial folds. In terms of skin texture and pores, I think Sublative would be a great option for you. Sublative rejuvenation is a deeper treatment that fights fine lines and wrinkles, eradicates acne scars, and improves overall texture by harnessing the power of energy currents to penetrate the skin and stimulate collagen production (while keeping the outer layer of skin intact). Depending on the selected course of treatment, downtime can vary from two to five days—which can be customized to fit your schedule and your needs. In general, I'd recommend an in person consult with a board-certified dermatologist to determine the best treatment plan for you.

Premature aging at 31, IPL laser not effective. Specifically, what can I do to slow down and reverse this rapid aging? (photo)

Answers (9)

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