How to lighten dark spots from doctor freezing age spots: I've been using tri-luma for 3 months with no results.

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

Certainly you are disturbed by this response to a treatment from your doctor.
Genetic backgrounds are much more important than most people realize. Hispanic, Asian, Middle Eastern and South American skin is quite sensitive, even though one would think otherwise.

Cryotherapy causes a lot of inflammation and that inflammation often results in dark spots from the increased melanin production. It is the body's natural response to injury and the more pigment potential in your skin, the more reaction from injury such as cryotherapy and many lasers. Likely some continued use of triluma will help, but it's not something you want to use for a very long time.

Sun protection and sun avoidance is critical to effective treatment whether that is a treatment cream or a laser-type device.

It is certainly difficult to avoid exposure in sunny climates, but if your skin is repeatedly in the sun, the spots may get even worse. Get a mineral sunblock, tint with a darker makeup to help mask the white cast as needed, and be fully dedicated to protecting your skin from UV exposure (that includes in the house and in the car).

Unless your skin is very dry, Colorescience makes an easy to apply powder sunscreen that you can dust on easily several times a day, and although a bit expensive, the amount in the container lasts a long while.

If your treating doctor is not a board certified dermatologist, please see one who has ample experience in the cosmetic treatment of Hispanic skin. There are devices that could help that are more friendly to ethnic skin, such as pico second lasers, but there's nothing that is a guarantee.

Thank you for your question.  CO2 laser skin resurfacing treatment is very beneficial for making acne scars diminish, removing age spots, increases collagen and elasticity production.  This is done by removing deeper layers of damaged skin and stimulating the regeneration of healthy skin underneath. This treatment is also beneficial for uneven pigmentation, photodamage, fine lines and wrinkles, precancerous spots, and a host of other skin imperfections and benign lesions. If you believe you may be a candidate for CO2 laser skin resurfacing treatment, a qualified cosmetic surgeon or dermatologist can carefully analyze your skin and determine if the procedure is right for you.

These spots can be improved with a combination of Cosmelan, lasers, Aerolase, microneedling/prp, skin lightening, peels, and skin care. Sun protection is essential. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Thank you for your question.  It looks and sounds like you might have Post Inflammatory Hyperpigmentation (PIH).  I'm not sure why people are still freezing pigment.  The results are not predictable and can make it worse.  We have 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 the underlying scar tissue.  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.

Time and SPF -  as the diagnosis is most probably PIH. PIH is usually dermal and requires your immune system to carry the pigmentation away. This process can be marginally sped up with lasers (including pico lasers and nano lasers), together with VEGF modulators. Pico offers a very marginal clearance over good old fashion nano lasers. See a dermatologist for a firm diagnosis and management strategy. Dr Davin S. Lim, Brisbane. Australia. 

Hyperpigmentation is very frustrating, and can be faded and blended with the rest of your skin over time with a combination of microneedling/ prp, sun protection with spf 30+, and Hydrafacial MD.Best. Dr Brecht