Which would you recommend; Picosure vs. IPL for brown spots and red, uneven skin tone?

Hi Consultant.  Both of the technologies you mentioned are options.  The concern we would have with IPL and brown spots is that it is underpowered.  An IPL is the "printer/fax/copier" of the laser world and it is not a laser.  Because it's not a laser, it has a much more difficult time permanently removing sun damage.  Permanent removal of spots is much better suited to q-switched lasers and Picosure is a q-switched laser.  So when it comes to Picture vs. IPLfor sun spot removal, we would choose Picosure.  With that said, we have spoken with many consumers about the prices for Picosure.  Because the device costs $300,000 physician;'s offices that have purchased it are generally charging 2-3 times what the same treatment would cost on a different q-switched laser treatment.  If you decide to go the Picosure route, make sure the office can show you before and after photos of THEIR OWN patients for the same type of condition you want to be treated for.For examples of before and after photos Los Angeles patients that have had q-switched laser treatments for brown spots at our office, click the link below.PS.  Red issues are very different and Picosure will not help with these.  You are better off with a pulsed dye lasers for redness.

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

I wouldn't compare over decade old technology to the Picosure.  If you want the best for your face, I would defiinitely choose Picosure over IPL.  There is no downtime, and no permanent hair loss.  It is excellent for treating brown spots.

Thank you for your question. Both lasers you mentioned treat different things. IPL photo facial treatment will blindly target the redness and brown spots but it will take at least 4 sessions and will likely affect the hair growth on your beard as a side effect. PicoSure is a gold standard skin rejuvenation option and it may remove your spots in 1 visit, maybe 2, provided you found an expert who can perform the treatment correctly. Most of my patients see a HUGE improvement after a single session for discoloration and it will not affect your hair and will give you a bonus skin tightening, but with extra sessions. IPL can only treat Brown/red spots. Regarding the redness on your face, it's difficult to pick an appropriate treatment for your concern because you may have rosacea or you may have visible capillaries from sun damage. The driver's side tan/damage is a very common concern but the treatment has to be adjusted accordingly. Less damaged side needs one set of setting, while the other different. If your red spots are capillaries or tiny veins, then Nd:YAG is your treatment choice. My practice offers all three services and I often combine them in one treatment day. Your concerns are not by the book and your treatment should not be by the boy either. Please find an expert provider in your area and have a formal consultation. Best of luck. Dr.Avaliani