IPL or CO2 laser: which is better for correcting hyperpigmentation and broken capillaries?

Question

I'm am 48 and have fair to medium skin with a lot of freckles and melasma as well as a good amount of redness from broken capillaries on my cheeks and around my nose. I am wanting to finally be rid of the unevenness and discoloration that has plaques me for years. Looking for m best option...maybe there is something beter

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Alex Eshaghian, MD, PhD · Answer

Thank you for your question marci.c. I understand your concern. An IPL photofacial is an
outstanding treatment for facial rejuvenation. It works by using bright light
to target and destroy pigment and redness in the skin. It is difficult to make an assessment without a
formal exam in the office where I can directly view the skin. However, I hope
the information provided here is useful.Melasma is a challenging condition to treat. It is characterized by the appearance of dark patches on the skin. Common areas of involvement include the forehead, cheeks, and upper lip. It is caused by an internal imbalance of hormones which makes the skin more sensitive to the sun, leading to pigmentation. Since the source is internal, on matter what is done on the surface, the condition will usually recur. Therefore continuous maintenance is required. The pigment in the skin can be deposited in the surface layers, the deeper layers, or most frequently both. While topical products and IPL photofacial treatments can help with superficial melasma, deep melasma requires a more aggressive treatment such as a fractional laser.For my patients with melasma I always start them on a skin care regimen including hydroquinone, kojic acid, retinoic acid, salicylic acid, vitamin C, vitamin E, hyaluronic acid, and sunscreen for one to three months. Then a combination treatment of IPL along with full surface resurfacing and fractional resurfacing is performed. The fractional resurfacing works by creating thousands of microscopic holes in the skin that act as channels through which the deep pigment can be extruded. Often times topical hydroquinone is applied immediately after the fractional laser treatment, which allows the product to pass through the channels and target the deep pigment. If using a fractional CO2 laser it is important to decrease or minimize the dwell time or pulse width. This is because longer swell times can generate heat which can exacerbate the melasma. I have used IPL and fractional CO2 lasers on skin types I-V. But caution is advised in those with darker skin types.For broken capillaries fractional laser to do not work. However IPL works well. Thus in the combination described above redness and broken capillaries can be treated along with discolorations from sun damage and/or melasma.Please consult with a doctor for specific
recommendations. Good luck!

Ray Bayati, MD · Answer

Hello,Glad you asked this question. I have seen some patients gone through different treatments and either didn't work or caused disfiguration as a results of treatments.I agree with Dr Tirgari's suggestions.in-person consultation with an experienced physician and second opinion before even deciding what to do.since I have not see any photo, it is hard to give specific answer but overall you could have other potential methods for treatment aside from IPL and CO2.Best -- Dr Ray

Reza Tirgari, MD · Answer

Both can be excellent options for most of what you've listed, although there is a wide range of factors to consider, most importantly your skin type and whether you truly have melasma.  If you do have melasma you will actually want to avoid both treatments as these could likely make your melasma worse.
It's hard to say without a photo, but I would strongly encourage an in-person consultation with an experienced practitioner.  Make absolutely sure that they are capable of treating melasma and are up to date on the latest treatment protocols.  You do not want your melasma getting worse.
Hope that helps.

Stephen Mandy, MD · Answer

Intense pulsed light is non invasive light treatment specifically designed for pigmentation and telangiectasias.  It is very effective especially in conjunction with skin lightening agents such as hydroquinone and topical tretinoin.  Sometime the vessels are too large for the IPL in which case a vascular laser, such as the KTP diode, is necessary to accomplish the job.

IPL or CO2 laser: which is better for correcting hyperpigmentation and broken capillaries?

Answers (8)

Answer: Pigmentation

Answer: Pigmentation

Answer: Hyperpigmentation and broken cappilaries

Answer: Hyperpigmentation and broken cappilaries

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IPL or CO2 laser: which is better for correcting hyperpigmentation and broken capillaries?

Answers (8)

Answer: Pigmentation

Answer: Pigmentation

Answer: Hyperpigmentation and broken cappilaries

Answer: Hyperpigmentation and broken cappilaries

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Recommended reading

Everything you need to know about IPL

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