How to treat pigmentation? (Photo)

Question

I have done multiple moxis and BBL (halo in the past) and I am trying to figure out how to better treat all the irregular and blotchy pigmentation. I have done the treatments on my neck and face and chest, and I just don't see the improvements I would like. I use medical grade skin care products. Currently using the Proven line, with supplemental Zo and Alastin products. Vitamin C in the mornings before moisturizer, and physical sunscreen.

Randal Haworth, MD, FACS · Answer

If you're not seeing the desired improvements in pigmentation despite multiple Moxi and BBL treatments, it's essential to discuss your concerns with a dermatologist or skincare professional. They can provide a thorough assessment of your skin, evaluate the effectiveness of previous treatments, and recommend potential adjustments or alternative approaches.

Consider exploring other advanced treatments like chemical peels, microdermabrasion, or different laser modalities, depending on your skin type and specific concerns. Additionally, your skincare professional may suggest modifications to your current skincare routine or recommend specific products tailored to address pigmentation issues.

Customizing a comprehensive plan with the guidance of a skincare professional will help optimize your chances of achieving the desired results for irregular and blotchy pigmentation.

A. David Rahimi, MD · Answer

Deep chemical peels (20-30% TCA or Phenol) and fractional Co2 laser resurfacing can remove deeper sun-damage and smoothen and tighten the skin. Consider finding an experienced dermatologist who performs laser resurfacing. I prep the skin for 2 weeks prior to the procedure with fadig creams and Retin A. Healing time is 5-7 days. Results can last for 5 years or longer. There is always a small risk of post-inflammatory hyper-pigmentation. These usually resolve with time and 8% hydroquinone cream and glycolic peels. I hope this was helpful. Dr R.

Raffy Karamanoukian, MD, FACS · Answer

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.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

David Hill, MD · Answer

While Moxi and BBL will often help even the pigment and reduce the very dark spots, you will likely require a more aggressive resurfacing, either with a CO2 laser or using a chemical peel to get to a deeper skin layer. Your skincare regimen is great and would allow you to heal fairly quickly (about 2 weeks downtime with either of the above recommendations).

Nuket Eroglu, MD · Answer

Hello; you have many freckles and keratoses; colored and colorless moles and sunspots on your skin. Moreover, genetically, you have a structure; which is suitable for staining. Moustachedarkness in your area; also, melasma make us think.Initially, it would be best to have; pico laser applied on your skin. Pico laser, without any harm to your skin; it will be a very effective solution for freckles and sunspots. Then, for vaporizing of moles, keratoses and for the overall clean appearance of the skin; fractional carbon dioxide laser treatment is implemented. The combination of these two lasers; it would be very efficient and permanent solution for you. In order to moisturize and protect for the skin; it is very important to use for right medical products. However, using for right medical products; it is not a solution for existing stains. After appropriate spot treatment with laser; it is also necessary to support it; with right products as well.

Roya Rakhshani, MD · Answer

I recommend having Enlighten laser which a pico genesis safe for all skin tones. You may require multiple treatments to have a successful outcome.

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