Which treatment for discoloration on my cheeks? (photos)

Question

I'm 32 (F) and have had severe acne after stopping birth control. It improved after taking Isotretinoin for 9 months. Now, I'm concerned about skin discoloration on my cheeks (pigmentation, scars, red marks). My routine includes sun protection, Vitamin C, and Differin 0.1%. I've been recommended treatments like CO2 Laser, PRP Lifting, Radiofrequency Microneedling, Vbeam, Q-Switch, and Pico Laser. Which method or combination do you reckon is best for me?

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

Nelson Lee Novick, MD · Answer

Consider professionally performed manual microneedling (no need for the added expense and risks of RF microneedling) in order to improve superficial color and textural irregularities. I have been performing this for over twenty-three years with consistently gratifying results for these kinds of issues. CO2 laser is an aggressive abrading technique that, much like dermabrasion, carries a protracted post-treatment healing period and downtime, and runs the risk for the subsequent development of a shiny, unnatural, overly tight, waxy (orange peel-like) skin. PRP is an expensive procedure whose results are quite variable and unpredictable. And the hard science to support the use of expensive treatments with fraxel laser and other energy-gizmos lags woefully behind the heavy marketing hype and social media buzz to promote them. So, a very hefty dose of "buyer beware" is in order when considering any of these expensive techniques. You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

Which treatment for discoloration on my cheeks? (photos)

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Which treatment for discoloration on my cheeks? (photos)

Answers (2)

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.