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.

Lumecca can be used on all areas of the body. The most common areas of treatment are zones that are regularly exposed to the sun. This often includes the face, neck, décolletage, legs, hands and arms. Sun damage and skin complexion results can be seen a few days after the first session. Theskin will continue to look younger and more brilliant over time with most visible results after 1-2 weeks. Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Thank you for your question. From the photo provided it does look like Hyperpigmentation. This needs a combination approach of peels like the cosmelan, and lasers like clear and brilliant and aerolase or laser genesis. Radio-frequency 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. 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.

Thank you for your question! Consider a combo treatment of BBL and Halo resurfacing by Sciton to address your sun damage.  This combination is ideal for an anti-aging effect and achieving a great complexion. Best of luck!

Thank you for your question. I have found that a light freeze will lighten 50% of hyper pigmented area. It is quick and inexpensive but again, not highly effective. If we cannot remove a dark spot with cryosurgery we usually use our IPL system which is more in the area of 85% effective for hyperpigmentation. If a single cryosurgery treatment does not show any effect we will often try a second treatment or move right to IPL. 

Consider a combo treatment of BBL and Halo resurfacing by Sciton to address your sun damage.  This combination is ideal for an anti-aging effect and achieving a great complexion  Hope this helps.

Thanks for your question and posting a picture.  I don't think freezing off age spots should be the current standard of care.  It looks like you have Post Inflammatory Hyperpigmentation (PIH).  You have multiple energy options developed this century.   If you are a skin type I-III, an series of IPL photofacials may be helpful.  We have also been very successful using the PicoSure laser with the FOCUS and / or Flat Lenses eliminating hyperpigmentation with a series of treatments.  FOCUS lens treatments have the extra benefit of reducing fine lines and wrinkles.  This is one of our go to treatments for patients older than 40 and worried about the signs of aging.  This laser is safe for all skin types.  Start with sunscreen every day!  Once you have treated your hyperpigmentation to your satisfaction, you will probably need a follow treatment every 6 to 12 months depending your level of re-pigmentation.  Best of luck.

What is the diagnosis, is this a skin cancer vs age spots or melasma. A dermatologist can identify your pigmentation and find a solution. Video explains.