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

I have had BBL (Broad band laser) treatments at least 2 or 3 times which did not seem to touch the redness and sun damage on my chest. I have also had IPL which didn't do anything. I have very thin skin and always cover it up in the sun now. It will look as red as this in the dead of winter. It blanches when I press on it—fyi, so it clearly seems to be capillaries close to surface. What about Excel V laser by Cutera? Is there any hope with lasers? Is bleaching cream too toxic or even effective?

Doctor Answers 4

Best treatment for the chest

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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.

Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Discoloration on the Chest

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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.

Rebecca Gelber, MD
Incline Village Physician


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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. 

David A. Sieber, MD
San Francisco General Surgeon
5.0 out of 5 stars 40 reviews

Sun Damage/BBL Laser/IPL/Excel V/What's Best?--Fraxel lasers, IPL, microneedling/prp, skin care, sun protection

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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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

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