The nitrogen freezing on my brown spots are not going away, what is my next step?

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

Depending upon the "spot" and your ethnic background, there are different options.

First, choose a board certified dermatologist. He/she can determine if your brown spots are better treated with RX topicals, a device, or a combination.

If your "spots" are actinic keratoses, then nitrogen freezing is typical. However, it's not always a good choice and especially so if you have ethnic skin which could respond with even darker spots.

Fraxel is a laser used to treat actinic keratoses and sun induced spots, but again, may not be a best option depending on your genetic background.

"White" skin is ideal for laser. Skin that tans easily is different story. Anything that causes inflammation (freezing or laser) can call up increased pigment.

Pico second lasers can help fragment pigment so it's more easily sloughed off and does so at pulse speeds that reduce the heat buildup that causes inflammation.

Thank you for your question. Your next step should be to contact a healthcare professional and  find out what type of  Bleaching products you can use for your particular skin type. Remember that when you are using products to "bleach" or "Lighten"  brown spots you should have a close relationship with your sunblock.  That is the most important part. If you are not good about using sun block try and fins a way to incorporate this as the most important step.  Hyper pigmentation of the area may occur when you do NOT use sunblock. Visit your health care professional for more information on how to lighten your brown spots.