Mild hyper pigmentation from previous acne and fine lines under eyes, around mouth and on neck. Co2 mild vs Cold Peel?

Question

Hello, I’m a 39-year-old female with mild hyper pigmentation from previous acne as well as fine lines under eyes, around mouth and on neck. What would be the difference between getting a mild CO2 laser versus a cold peel? Would you recommend one of these or more so go with an IPL type laser for my concerns. I am not seeking medical advice just your opinion :)

Erik Peterson, MD · Answer

Hi! Dr. Peterson here &mdash;
Great question. A mild CO2 laser is a resurfacing treatment that goes a bit deeper, so it can help with fine lines and texture changes while also improving some pigment. Recovery is longer than a peel, but results tend to be more noticeable.
A “cold peel” (like a light chemical peel) is much more superficial. It freshens the skin tone and can help very mild discoloration, but it won’t do much for lines or texture.
IPL is different again. It’s a light-based treatment that targets redness and pigment but doesn’t really smooth lines or change texture.
For someone with both pigment and fine lines, I often recommend either a fractionated CO2 (in a lighter setting) or combining approaches &mdash; sometimes a laser for texture and fine lines, and a light-based treatment for pigment. A board-certified dermatologist or dermatologic surgeon can tailor the plan based on your skin type and downtime preferences.

Nick Slenkovich, MD · Answer

Hello! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center.  If you are dealing with mild hyperpigmentation and fine lines, CO2 laser and a Cool Peel can both help with texture and pigmentation. Cool Peel offers similar benefits with less downtime, making it a good option if you want a more gradual improvement.  IPL is great for pigmentation and redness but doesn’t do much for fine lines or skin texture.  If you’re looking for overall skin rejuvenation with some downtime, Cool Peel might be a nice middle ground.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

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