Removing small pigmentation spots from face (photo)

Question

Hi there, I am 47 y/ o male with hyperpigmentation spots because of bad suncreen use while surfing. Have done 2 TCA 18% Peels, which has done nothing. With the TCA Peels I stayed at home because the peeling was very bad looking. Now i want to remove the pigmentation with small spots at a time. Is it possible to do just the two spots between the circles. Will it be just two little scabs for a few days so I can still go to work? Don’t want to do my whole face at one time and having a face full of scabs. Also are the scabs even big as the treated spots? Thank for all the advise!

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. I recommend Pico laser for your case, especially considering your goal of treating only a couple of hyperpigmented spots while minimizing downtime. Unlike TCA peels, which affect broader areas and often result in significant peeling and redness, Pico laser offers precision targeting of pigmentation with minimal damage to the surrounding skin. This makes it ideal for treating small areas—like the two spots you're focused on—without the need to take time off work. After treatment, you might notice some mild redness or very small scabs that resemble tiny bug bites, but these usually fade within a few days. Most people are able to return to work and daily activities immediately after a Pico session. It's a great option if you're looking for effective pigment reduction with a fast recovery and less disruption to your routine. I hope this helps and best of luck!

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

Anna Chacon, MD, FAAD · Answer

When it comes to treating small pigmentation spots on the face, especially after previous treatments like TCA peels, there are several options to consider. Here’s a guide on how you might approach this situation:

Targeted Treatment Options:

Laser Therapy: Fractional lasers or Q-switched lasers can target specific pigmentation spots. These treatments are precise and often result in minimal downtime. The spots may become darker before they flake off, usually within a week.
Cryotherapy: This involves using liquid nitrogen to freeze the pigmentation spots. It can be performed on small areas, resulting in small scabs that typically heal over a week.
Spot Peels: Instead of treating the entire face, your dermatologist can apply a chemical peel only to the pigmented spots. This could lead to small scabs directly on the treated areas, allowing you to continue with your daily activities.
Expected Healing:

The size of the scabs generally corresponds to the size of the treated spots. After treatment, you may have small scabs that cover each spot, which should heal and fall off in about 5-7 days.
During the healing process, it's important to avoid picking at the scabs to prevent scarring.
Consultation with a Dermatologist:

Before proceeding, it’s advisable to consult with a dermatologist who can assess your skin type and recommend the most suitable treatment. They can also provide a more accurate estimate of downtime and potential side effects based on the specific method used.
Post-Treatment Care:

Consistent use of sunscreen is crucial to protect treated areas and prevent further pigmentation.
Gentle skincare products should be used to avoid irritation while the skin heals.
By targeting only the specific spots, you should be able to minimize downtime and maintain a professional appearance at work. Always ensure that any procedure is performed by a qualified healthcare professional to achieve the best results and minimize risks.

Removing small pigmentation spots from face (photo)

Answers (3)

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