Best Treatment for Brown Spots and Large Pores on Asian Skin?

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi Asianskin,
Asian skin is difficult to treat for melasma and brown spots. Fraxel re:store at low energy levels and low densities have been successful in many patients, but unsuccessful as in your case with many other patients. There is an increased risk of post inflammatory hyperpigmentation (PIH) in Asian skin. Fortunately, over time, the darkness will fade.
In those patients that do not respond well to the series of Fraxel re:store treatments, I have been using Cosmelan peel treatment with very nice results. There is another melasma/dark spot peel called Melanage` that is also quite good. I would recommend one of those peels along with sun protection/avoidance.
Good luck and be well.
Dr. P

Hi,

It sounds like you may have what we call temporary post-inflammatory hyperpigmentation after your Fraxel Restore treatment.  It is best treated with a bleaching cream that includes hydroquinone.  We treat many Asian patients with Fraxel Restore and we prepare them by putting them on a bleaching cream before Restore and occasionally after Restore to prevent PIH.  With Asian skin there are also optimal Restore laser settings to achieve your desired result.  The good thing is that your pigmentation is not permanent and will go away.  The best thing for you to do is to start a cream with hydroquinone and use a sunscreeen with a minimum SPF of 45 that contains a physical sunblock like zinc or titanium.

 

Best,

Dr. Liu

It sounds like you have post-inflammatory hyperpigmentation after the Fraxel treatment. Bleaching creams and sunprotection will help fade it out. There are many possible diagnoses for the light brown spots around your eyes that were treated with Fraxel. Without seeing pictures it is impossible to say if these are lentigines (age spots), acquired nevus of Ota, freckles, melanocytic nevi, or seborrheic keratoses. Best laser treatment depends on the diagnosis and the depth of pigment. For example, my favorite treatment for lentigines is Q-Switched Ruby laser. The QS 532nm works well too, however, may result in temporary bruising. Prior to having laser treatment of pigmented lesions, remember to have your dermatologist check your brown spots to make sure they truly are benign.

You need to be very careful about laser treatment performed to your skin. Ethnic skin tends to be more sensitive and prone to hyperpigmentation. Even more minimally invasive lasers like the Fraxel can cause problems. Fortunately, most hyperpigmentation is temporary or can be treated with skin lightening agents like hydroquinone. I usually have my patients on a skin care regimen of hydroquinone and Retin-A before laser therapy to optimize the skin prior to treatment and to reduce the risk of hyperpigmentation. I would wait for your current hyperpigmentation to resolve before considering repeat treatment.