Which procedure is best for pigmentation? (Photo)

Question

Hello, I’ve had freckles my whole life, I wanted to get a procedure that would lighten them along with helo with fine lines and also a minor scar I have on my cheek. I’m between the co2 laser I Feel it’s more cost Davy to do the ablative since it’s a one and done but I’m not sure my skin is mature enough for somethig as string so I was told the fractional. My question basically is which procedure is best for pigmentation? And if it’s worth doing ablative to save money and time

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.​

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello Dazzling915004! My name is Jessica, I am a physician assistant, and one of the providers at Shah Facial Plastics. Based on your concerns, I recommend trying the PiQo laser. This is a great laser that is used specifically for hyperpigmentation, brown spots, sun spots, and skin rejuvenation. I highly recommend! I hope this helps and best of luck!

Nadir Qazi, DO · Answer

When it comes to treating pigmentation, fine lines, and minor scars, both CO2 ablative and fractional laser treatments can offer positive outcomes. The choice between the two depends on several factors, including your goals and your comfort level with the recovery process.

CO2 ablative laser treatments are known for their comprehensive rejuvenating effects. They can effectively address pigmentation issues, fine lines, and minor scars by removing the outer layers of damaged skin and promoting collagen production. While they typically involve a longer recovery period due to the more extensive tissue removal, they can provide dramatic results in a single session.

Fractional lasers, including fractional CO2 lasers, are designed to treat only a fraction of the skin's surface, leaving surrounding tissue untouched. This results in a faster recovery compared to ablative lasers. Fractional lasers can also effectively target pigmentation, fine lines, and scars by stimulating collagen production and skin renewal.

If your main goal is to address pigmentation while also improving fine lines and a minor scar, a fractional laser treatment could be a suitable option. It provides significant results with less downtime compared to ablative lasers.

While the cost and time-saving benefits of an ablative laser might be tempting, it's important to prioritize your skin's health and well-being. If your skin isn't quite mature enough for a more aggressive treatment, a fractional laser could provide a balanced approach to achieving your desired results while ensuring a comfortable recovery.

Your individual needs and goals are unique, so I encourage you to have a thorough consultation to determine which procedure aligns best with your expectations and skin's condition. Taking the time to make an informed decision will help ensure a successful and satisfying outcome.

Sara Salas, MD · Answer

If hyperpigmentation is your main concern, I do not recommend Co2. There are other lasers such as PICO laser that would help you with hyperpigmentation, since this is a technology specially design to treat that. The combination between laser, at home topical treatment, and medication can give great outcomes!

Which procedure is best for pigmentation? (Photo)

Answers (5)

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