I am a 53 year old Asian female. I was using .05% Atralin, a pea-size amount once a week for 3 ½ months to remove some light brown spots on my face. I stopped using it when I notice broken capillaries. The PA at my derm office said that I should continue using Atralin. It will fix (remove?) the broken capillaries. Is that true? What are my alternatives to get rid of the brown spots and broken capillaries? Is microdermabrasion an option? Also, it is true atrophy is a possibility with laser/IPL?
Brown Spots and Broken Capillaries - How to Get Rid of Them?
Doctor Answers 3
IPL improves both brown spots and broken capillaries
Atralin is a vitamin A drug most commonly used to treat acne by exfoliating the skin and stimulating cell renewal. Even though it is often prescribed to reduce brown spots, it may not be the best option for you since it is causing irritation.
The Atralin will not improve capillaries, in fact it can cause them to worsen over time. The alternative for you would be an IPL that can be safe and effective in reducing both your brown spots and your broken capillaries. Theses treatments can actually stimulate some superficial collagen and improve you cosmetic benefit.
Light brown spots and red capillaries are best treated with lasers
The red capillaries can only be treated with lasers. No topical products will help their improvement. A pulsed-dye laser or VBeam would be the best for this.
The brown spots could be caused by a variety of conditions, and they should be evaluated by a dermatologist. However, if they are simple lentigines, a Q-switched laser is the best to remove them. IPL is intense-pulsed light and will not remove the red or brown, but will lighten them. IPL does a lot of things okay, while lasers do a few things really well.
Again, the Atralin will not help the red capillaries, nor will any topical product.
Unless you get a scar from the laser/IPL you will not develop atrophy.
Remove brown spots and broken capillaries
Your main problem is light brown spots and broken capillaries.
Treatment options for this include a comprehensive skin health program such as Obagi, which uses retin-A (Atralin) with alpha-hydroxy acid/hydroquinone creams. This is used daily. I have never seen any benefit from using only retin-A weekly in such small amounts. In the Obagi program, we use 0.1% retin-A with the other products to get rapid resolution of age spots and pigmentation.
I do not think broken capillaries are related to using retin-A once a week. This is a separate problem related to chronic ultraviolet damage and the aging process. Retin-A will not help capillaries at all.
Effective treatment for pigmentation and brown spots include the Palomar IPL (intense-pulsed light), and the Palomar Lux 1064 YAG laser which is used for small blood vessels on the face and spider veins on the legs.
Lasers or IPL are needed to treat blood vessels, otherwise they will never go away.
Microdermabrasion is a very superficial treatment that has temporary results that are the result of removing only the most superficial layer of skin cells. It is more cosmetic than therapeutic, and only can remove small amounts of very superficial pigment.
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