Dark Pigment on Smile Crease and Depressed Lines! african american. Are These Good Options For My Issues? (photo)

This is physics.  Photofacial work when there is a significant color difference betwee the skin being treated and the thing you are trying to treat.  With increasingly dark skin, so much light is absorbed that it can blister the skin (a bad thing).  This damages the skin.  To avoid this, energy has to be reduced so much than no work is done with the treatment.  So no, photofacials not a good option.  Fillers are probably a much better way to go.

Photofacial is the absolute wrong choice, and if a physician recommended that to you, you must go elsewhere.  You likely have postinflammatory hyperpigmentation which should be treated topically with prescription strength creams ( I prefer compounded 8 percent or higher hydroquinone). If there is any ongoing irritation, that needs to be treated as well.  That can be easily missed in darker skin becasuse the pigment may mask underlying redness.   Other topicals can help as well.  Please realize that all topicals take many, many months to work.  Fillers will help with the lines and may improve the look of the pigment if there is any shadowing.  This can only be assessed in person.  Best to you.

IPL is very hard to do on darker skin, especially when you are trying to target specific, even darker, pigment. If you are going to do this, I would do it an extremely well trained physician's office who has extensive experience treating darker skin tones. However, before I even went down that road, I would recommend an Rx of hydroquinone (8-12%) to see how much of the discoloration could be removed from this. A cosmetic dermatologist should be able to get you a prescription for this from a compounding pharmacy. After treating the discoloration with topicals for several months, then I would evaluate the possibility of doing fillers, like Restylane.