Best Treatment for Olive Skin with Age Spots, Sun Spots, Melasma?

I'm 47, light olive complexion w/ pinkish undertones, brown eyes and dark brown hair; was very active in sports from age 7 through 20's-prior to the emphasis on the importance of sunscreen & sun damage to exposed skin.

After 1 year of 4% hydroq., 0.4 retin A., and 4 IPL Tx's, no significant improvement is noted. The treating dermatologist of IPL(Nashville) states that my tx options are limited, states it's hormone related. Not much available for my skin type/color. A plastic surgeon (Chattanooga) advises against CO2 resurfacing.

Continued HQ and Rentin A have no significant impact. Have you successfully treated cases similar to mine with Fraxel repair?

Doctor Answers 2

Melasma in your skin type is difficult to treat

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Hi AG,

Melasma in your skin color type has been a very difficult condition to treat. Fraxel restore is probably the best technology to try to treat the melasma. It must be done very lightly at 3 to 4 week intervals.

We have seen significant improvement in about 80% of patients, the other 20% do not respond well. It sounds as if you are now taking excellent care of your skin and with avoiding sun exposure. In the 80% responders, there is a tendency toward recurrence during and after "sun vacations" if there is more sun exposure.

Melasma is an ongoing condition and is certainly influence by hormonal levels. You will be glad to know that it took me longer than the obligatory 5 minutes to type this (just kidding). By the way, U of Tennessee's "Rocky Top" is a favorite of ours, go Vols! Be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

There are options for ethnic skin

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Age spots and melasma can be treated althought it is a difficult thing to treat. IPL's, and all types of resurfacing can improve the appearance of these conditions. IPL treatment can affect deeper pigment. Sometimes the cooling will protect the more superficial pigment and hence this can stay within the skin and also prevent penetration of other lasers.

Sometimes you need to combine very superficial peels or resurfacing to the mix to improve more superficial pigmentation. Very light co2 resurfacing can also be used to decrease the more superficial pigmentation. Also, light peels and even microdermabrasion can help your skin pigmentation by allowing the topicals you are using to penetrate deeper into the skin to affect the cells that are dispensing the pigment into the surrounding skin cells. I would also add a topical steroid to the mix of your other topicals. Stronger topicals can also be used as well to help the situation.

Philip Young, MD
Bellevue Facial Plastic Surgeon

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