Best course of treatment for freckles, broken capillaries, and fine lines/wrinkles? I don't know where to even begin.

Question

I have a ton of sun damage in the form of freckles, forehead wrinkles, and crows feet. I'm 29 and I'm really noticing the damage now even tho I do take good care of my skin now. I also have broken capillaries around my nose. There are so many treatments out there- PicoSure, Lumecca, microdermabrasion, etc. I was wondering what I would get the best results from and not do anymore damage to my skin!

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Adam Scheiner, MD · Answer

Dear Nadia,Sun exposure does cause problems with our skin. The first thing to do is to start protecting yourself when you're outside with sunblock daily. Certain medications like RetinA and hydroquinones can be helpful .For more improvement BBL or IPL can help.For better improvement, it would require deeper surgical procedures with recovery time.My RESET treatment is helpful in reversing past sun damage. I'll include some links below.I hope this was helpful.

Jeffrey H. Spiegel, MD · Answer

Nadiagrace,You have pigmentation, fine lines, and sun damage.  A great way to start is with IPL which will help reduce all of those things.  That with a good sunscreen and the rights skin care lightener will get you looking good.Best of luck!

Elbert T. Cheng, MD · Answer

Hello, thank you for your question. A good place to start in eradicating these imperfections is
Intense Pulsed Light (IPL) Lasers. This will treat your issues of sun damage and capillaries. To
treat fine lines and wrinkles, microneedling could be a great option for you and is it uses
minimally invasive tiny punctures in your skin to arouse natural collagen in your body and
tighten your skin. I recommend you schedule an in person consultation with a certified
dermatologist or surgeon so they can tell you what would be best for you personally. Also keep
in mind that the best skincare lies in prevention so it is extremely important to wear sunhats and
attempt to keep your skin covered if possible, and wear sunblock!

Onir Spiegel, DDS, PhD · Answer

Hi Nadia,
Your problem can probably be easily solved with just a few (usually 2-4 sessions) of IPL or Erbium.  Just make sure the place you go to has the new Rohrer Laser.  It's probably the best machine out there right now.  You'll be shocked how fast those imperfections go away.  Another thing to think about are good skin products.  I love the Defenage line and the SkinMedica Lytera 2.0 for the problems you listed.  Hope this helps.  Dr. Onir

Vicki J. Levine, MD · Answer

Most important is to wear sunscreen  with an SPF  of 30-50 every single day . Your blood vessels can be treated with the pulsed dye laser, Botox for the lines and the Ruby laser for freckles

Sheryl D. Clark, MD, FAAD · Answer

Dear Nadiagrace88:There is more than one modality that would be effective for your issues, including Fraxel, LaserGenesis and microneedling with PRP. Considering your age, I think you would see the most benefit at a reasonable cost with a few LaserGenesis treatments. Whatever you do, you will want to begin a regimen of high-quality topical agent to promote and maintain the results.All the best,   Dr. Clark

Best course of treatment for freckles, broken capillaries, and fine lines/wrinkles? I don't know where to even begin.

Answers (8)

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