Best Melasma, Redness and Large Pores Treatment for Sensitive Skin?

I am 33 years old, and have sensitive skin (i.e. I don't respond well to glycolic acid). My cocerns are: slight browness/possible melasma on my forhead; redness in my cheeks, and enlarged pores by by nose. My pores and uneven redness on my cheeks are my biggest concern. What would be the best option: IPL, Fraxel Restore, or Laser Genesis? I heard that IPL can make melasma worse; is this true? It was also recommended that I try Silk peel with the Laser Genesis. Would you advise that? Thanks.

Doctor Answers 2

Multiple problems, multiple solutions

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You mention that you are concerned with brown discoloration, redness, and enlarged pores.

The best treatment for redness and broken blood vessels is the pulsed dye laser. There are several different "brand" names for pulsed dye lasers- what is important is the wavelength of the laser because it is the wavelength of the laser that tells you what you are going to treat. Don't get caught up looking for a particular name of a laser treatment.

The best treatment for brown discoloration depends on the type of discoloration that you have. Not all brown is melasma. And not all melasma responds to chemical peels. In fact, a lot of melasma does not respond to chemical peels at all. Fading creams containing hydroquinone applied nightly, combined with diligent use of high-SPF sunscreen and sun avoidance, may be your best option for fading melasma.

If you have redness and brown spots/freckles from aging or sun exposure, IPL might be a good option. IPL treats both red and brown pigment, and is a more gently approach. This also means that it will require several treatments to see much improvement.

There isn't much you can do about pore size. Your genetics determine your pore size for the most part, but you can make the most of what you've got. Keeping your skin clean with a good skin care regimen and using products that promote collagen building (like retinoids and peptides) will help. Avoiding behaviors that damage collagen like smoking and sun exposure, to slow down the aging process as much as you can. As we age and the skin gets more loose, the pores become more noticeable.

Washington Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.