Stubborn pigmentation/melasma? (photo)

Question

Hi there! I have stubborn pigmentation from prior sun damage/acne, melasma from pregnancy, and ruddiness/redness from rosacea. I have tried IPLs, clear and brilliant, VI peels at the dermatologist. I use retinol, hydroquinone/arbutin, vitamin C, and sunscreen religiously in my routine. What else would you recommend for someone like me? I'm willing to deal with some intense downtime if the results will actually be impactful. Thank you in advance!

Anil R. Shah, MD · Answer

Hello! I'm Landry - a medical aesthetician at Shah Facial Plastics - located in downtown Chicago and Winnetka.

Since you do have Melasma, I'd highly suggest to stop with IPL treatments as heat based treatments will worsen pigment. Instead, I'd suggest a pico laser. The PicoLazer that we use in office is a non-thermal solution to reduce and remove pigment. Another effective treatment is either oral or topical tranexamic acid. Both together would boost your targeted goals of controlling melasma.

Take care and I wish you the most luck with your treatment journey!

Paul Flashner, MD · Answer

Hi! Looks like melasma from this picture. IPL/photofacials are NOT recommended for melasma! It can make it worse. We use the Pico laser to treat melasma. It is not a quick process since the process works through your lymphatic system. You may need about 6 treatments to see improvement, preferably in fall or winter because of sun exposure. Also using a product with tranexamic acid is recommended or hydroquinone during these treatments.

Raffy Karamanoukian, MD, FACS · Answer

Vbeam laser is an excellent modality for patients who have rosacea, blushing of the skin, facial and body telangiectasia, spider veins, redness, post surgical redness, and skin flushing. It is a safe procedure that can be used at varying depths to help treat micro blood vessels in the skin. We also use it in our office for facial skin inflammation, keloids, and hypertrophic scarring. It is an important part of scar therapy. Vbeam can be combined with chemical peels and other lasers, but experience with the treatment is essential. The Vbeam laser does not affect deeper tissue. Schedule a consultation with an expert in Vbeam and you will find it to be an excellent modality for many skin types. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Stubborn pigmentation/melasma? (photo)

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