Is there any specific effective treatment for these spots? Is there any cream for it? (Photo)

Question

There are spots over my 1/3th of upper calf and popliteal fossa. It’s been there since birth. I feel they are cafe au lait. I have one big cafe au lait over my cheek and forarm too. But i am comfortable with it. While these marks over calf are more in number and not appealing to eye and making me less confident. Is there any treatment for it? Am i in high risk zone for neurofibromatosis 1? Can you suggest me some cream for it? Laser treatment will cause recurrence or any side effect? Do reply.Thank you!

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. 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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

this pigmentation needs cosmelan peels, at home vivatia treatment and pigmentation suppression skin care long term.  lasers like Aerolase help with hair removal and pigmentation but this will need life long treatment as its often from genetics (folliculitis) and rubbing. 
Hyperpigmentation from any type needs a combination approach of peels like cosmelan,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

Sanjay Azad, MS, FRCSEd · Answer

Thanks for the photos.I would recommend a punch biopsy to get a diagnosis first and then proceed with an expert dermatologist or plastic surgeon to see what can be done. Pathology is a key as this will provide a conclusive diagnosis before treatment.

Anshul Gambhir, MD · Answer

Hello. I don't think a cream will help much in this case.  I would suggest using a qswitched laser or another device which helps with the pigmented of tattoos. It should help to safely get to the deeper pigment and break it up.  You may need 10-12 treatments at least.

Is there any specific effective treatment for these spots? Is there any cream for it? (Photo)

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