No idea how all these dark little marks showed up randomly but I want them gone - advice? (Photos)

Question

My skin is absolutely horrific. What can be done for all of these dark marks all over my face? I did not suffer from acne or anything of the sort. They sort of just "appeared" overnight. I do not want to do topicals because my skin is extremely sensitive. Are there lasers to help with this?

Raffy Karamanoukian, MD, FACS · Answer

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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

​Hyperpigmentation of any kind needs a combination approach of peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly,; lasers like Clear + Brilliant, Aerolase or Laser Genesis; radiofrequency like Venus Viva; and constant skin care and sun protection. Bimonthly facials with SilkPeel DermalInfusion are 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. Hypopigmentation will need more of an evaluation and possibly additional lasers to get improvement. I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.​

Diyanah Bani Hani, MD · Answer

Hi there! 
These skin changes are likely from sun exposure and it can also be worsened by hormonal changes. I recommend that you find a provider in your area that offers Moxi laser. Be patient because it usually takes several sessions but it will be worth it! 
 Wishing you so much good luck on your self-care journey!
Diyanah Bani Hani, MD

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