Should I go for IPL treatment to remove pigmentation? Brown and dark brown patches on my face due to acne and sun exposure.

Question

I have an Indian skin tone. My skin is vulnerable to sun damage. I have got brown and dark brown patches on my face due to acne and sun exposure. Sun damage is chronic. I am using benzoyl peroxide for acne, acne is so far under control. Now I'm seeking a treatment to remove pigmentation. How convincing it is to go for IPL treatment? Moreover, how many sessions do I have to go through to get rid of pigmentation and get an even skin tone?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Kimberly Butterwick, MD · Answer

While IPL is a good option for treating brown spots in some skin tones, I would recommend a laser like the PicoWay for your specific situation. This laser features a rapid pico-second pulse that shatters the melanin that creates the brown patches, eliminating it with minimal damage to the surrounding tissues. In addition to being more effective, this laser is also one of the safest for your skin tone. Usually one to two sessions are needed. Make sure you are working with a board-certified dermatologist with expertise in both lasers and working with a variety of skin tones to ensure your procedure is both safe and successful. They will also counsel you on an effective regimen to maintain your results.

Matt Tahsini, MD · Answer

Hello and thank you for your question. Laser treatment is certainly an option for you. That being said, you need and in person evaluation to see what option is best for your skin type and color. Be sure to find a very experienced medically provider. Best wishes to you,
Dr. T

John Quinn, MBChB · Answer

Hello!
Thanks for your question.
I have been using IPL for 10 years now. It is a wonderful treatment for benign, pigmented lesions on paler, Fitzpatrick skin types 1-3. I would never recommend IPL for Indian skin. The risk of skin injury and subsequent pigmentation issues is just too high. 
You appear to have some whiteheads as well as diffuse, patchy pigmentation. I often prescribe topical retinoids in the this scenario. I would suggest seeing your GP in the first instance. If you do decide to have any laser treatment, it is important to see someone with specific experience in treating your skin type.

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