I have a Café au lait birthmark on the side of my nose, what is the best treatment? (Photos)

Thank you for your question. This needs a combination approach of peels like cosmelan, lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection. Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. If you have acne you can do additional treatments and peels to get more improvement. I recommend getting a formal evaluation with a cosmestic dermatologist. Best, Dr. Emer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thanks for your question and posting pictures.  The good news is the birthmark is dark and you have lighter skin.  That is a good combination for energy devices.  Unfortunately, there isn't one device that will work on everyone for this.  After a consultation in a medical setting, we would probably start with our highest success option of the PicoSure laser with either the FOCUS and / or Flat lens.  Some physicians on this site have also suggested a tattoo laser.  We could also try the PicoSure in tattoo mode for a test spot.  None of these options should make it worse and more than likely one will work very well to minimize or even eliminate it.  I hope this helps.