Help, I have hyper and hypopigmentation on my face. Is this plan right for me? (photo)

Hyper and hypo pigmentation skin, my skin therapist suggested me to have 2 micro needling and 2fraxel refine. Plus Obagi nuderm system home care products . She gave me 4%hydroqionu pre-treat the skin before the Fraxel. Is this a good plan for me?

Doctor Answers 5

Red, hyper and hypo pigmentation of face - Melasma

This looks to me like melasma. I'd be cautious at first. I would use the Obagi, and chemical peels for 3-4 months. Afterwards, consider Fraxel or Spectra QS laser treatment. This is a difficult problem to fix you must know. Lasers can cause worsening of this problem so trying conservative measure is always the safest. Chemical peels are the mainstay of therapy in most cases. I don't have experience using PRP for this problem but other docs recommend it. I do recommend Heliocare as well as absolute sun protection. Antioxidants are also recommended because this is felt to be an inflammatory process.


Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Combination treatment required

Honestly, your case is complicated with a mix of acne, hyperpigmentation (melasma?), post inflammatory erythema, hypopigmentation, and scarring. It is hard to give you a treatment plan without seeing you in person. What I can tell you is that it would be beneficial for you see an experienced physician for an in-person consultation. 

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 60 reviews

Hyper & Hypopigmentation--Lasers (Fraxel, Co2/Erbium, VIVA, Intensif); Microneedling/PRP, Fillers (Bellafill); Subcision; Punch

This needs a combination approach of lasers and microneedling. It should be tailored by an expert.  Please get a formal consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Chemical peels - Vi peel

You did not mention your diagnosis but it looks like you are developing melasma. It is tricky to treat melasma since there is no cure for it, just treatments that improve the overall appearance of your skin. Some lasers trigger even worse outcome. Chemical peels are safe treatment for the beginning while I would suggest you do be careful with laser treatment. I advise you to look into Vi Peel. It is important that treatments are spaced out enough. Obagi nuderm system is good home care regimen. Good luck! 

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Melasma and Scars

I do a ton of Fraxel laser in my office but Fraxel does not appear to be the laser that would be best for you.  You appear to have melasma and scarring.  I would opt for chemical peels with hydroquinones for pigmentation or Cosmelan with V-Beam for redness.  Please consult a board certified dermatologist.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

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