What is the best laser to treat sun damage discoloration on chest? (photos)

We prefer Lumecca over BBL since it has more energy focused on the 500-600 range and typically treats reds better in our experience.  Improving texture of the decollete area often involves several modalities to provide the maximal benefit:
Ablative laser resurfacing- Fractionated C02 resurfacing or erbium at a lighter setting can help build up collagen
Fractora- RF needling can help improve the texture and collagen creation in the skin here
IPL- can help improve the brown spots and discoloration of the area
Melanage or Cosmelan- Peels can help improve the appearance of the discoloration
Sculptra- Dilute Sculptra can help improve the texture of the skin and crepy appearance of the skin.

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

It can take multiple treatments to deal with sun damage. I recommend a combination treatment of Fraxel lasers, IPL, microneedling/prp, rather than a bleaching cream.  It is best to make a formal consultation with a cosmetic dermatologist who can come up with a long term solution. Best, Dr. Emer.

The Forever Young BBL is the ideal treatment to target sun damage and redness on the face and body. For larger body areas, the BBL HERO is ideal as it works at significant speeds and comfort levels.

I agree with the other responders to your question that BBL should effectively treat the changes you describe.  It is possible that the selection of settings and/or the hand piece filter were not optimized for your skin changes.  The chest will be more at risk than the face for adverse effects if treatment is too aggressive.  See a physician with extensive BBL experience, and keep in mind that at least 3-5 treatments will be necessary.  

Technically what you have is called poikiloderma - it's when you see that combinations of browns and reds and usually happens on the neck of people with sun damage. I have a practice in the mountains of Lake Tahoe so without treatment, most all of my patients start out with it.

Although it hasn't been your perfect fix to date, I do find the backbone of treatment is a series of 4-6 sessions of BBL performed by an experienced user with the settings that only experienced users are comfortable with. For almost 3 years now, I have been combining BBL with the Halo laser in the same setting. This laser, if used appropriately, is very safe of the face and you get exceptional results in an average of 3 settings combining BBL and Halo in the same treatment.

The very best to you.

Thanks for the great questions and the photos. When down properly, BBL should be able to remove the pigment and redness in your skin. Often times it takes 3-6 treatments with BBL until the skin has lightened significantly. The problem with using lasers on the neck and chest is that the skin there is thin and does not have the same about of blood vessels in it as the face. This means that the neck and chest is much more likely to have burns, hypopigmentatio, and scaring after being treated with lasers. If you are interested in coming into my office for a free consultation I would love to meet you in person and see what I can do to help get rid of this sun damage.