Q switch laser for facial birthmark, what else can I try to remove this? (photos)

This can be improved with tattoo lasers. It will take a series of treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Thanks for your question and posting a picture.  Since your concern is primarily the brown pigmentation, we would probably recommend a series of PicoSure FOCUS and / or Flat lens.  We like it because it is safe for all skin types.  It was worked well for most of our patients.  Our patients typically need a series of 3-5 treatments.  You will need to wear a medical grade sunscreen to help keep the area protected.  I hope this helps.

The Picosure at 532 is a filtered laser. No doubt the pico laser is excellent for skin rejuvenation in cases pertaining to its application, however old fashioned nano or QSL for tattoos do a better job than state of the art Picosure in THIS case. Pico way or Enlight has the power, as the end point MUST be frosting. See a dermatologist for diagnosis and management. This size should only take 1-2 treatments at most, especially in your skin type. All the best, Dr Davin S. Lim