IPL or Chemical Peel for sun spots, red acne spots, uneven skin tone and large pores? (Photo)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian

Based on your photo, it does appear that IPL would be a good place for you to start. This light therapy works well to reverse sun damage like brown spots. However, you would likely see the best result with a combination approach to address your various concerns. A vascular laser like Vbeam might be the best choice for your red spots, while a laser device like PicoSure might produce better improvement of the brown spots. I suggest scheduling a consultation with a board-certified dermatologist who has expertise in laser devices. With a treatment plan customized to your precise needs and skin tone, you are likely to see an excellent result. 

Overall for pigmented and red lesions IPL is preferred, it works well for uneven skin and improving pore size. 

Unfortunately, as with many such light and energy-based bells and whistles out there, IPL has a lot more medspa hype than scientific substance to back up its use. For widespread mottled pigmentary problems, such as appears to be the case in the photos, you would likely profit most by a combination of at-home prescription topicals and an in-office series of superficial chemical peels, which will also help to improve overall skin quality.  Tri-Luma is a prescription topical that may be tried. Others include hydroquinone in higher concentrations, kojic acid, azelaic acid, arbutin, licorice extract and topical (and oral) tranexamic acid. In-office superficial peels include glycolic acid or salicylic acid in high concentrations, Jessner's Solution, or low concentrations of TCA. Typically a series of six to eight peels are necessary to achieve optimal improvement, and once improvement is achieved, which typically takes about six to eight months, then one of the non-steroidal brightening agents mentioned above may be continued indefinitely along with sun protection to prevent recurrence.  Professional microneedling along with TCA 15% has also proven useful for these kinds of issues. Make sure that you are consulting with a board certified aesthetic dermatologist. Best of luck.

The IPL® photofacial is the gold standard in treating sun damage and hyperpigmentation to reveal skin that is brighter and more even. With the use of IPL (Intense Pulsed Light) technology, the IPL® photofacial treatment is typically used to treat sun spots, spider veins, hyperpigmentation, and improve skin tone by targeting of hyperpigmented or otherwise damaged skin cells with the use of specific intense light wavelengths.
As the light penetrates your skin, it’s converted into heat, which then destroys any hyperactive skin cells in the process and causes the pigmentation to disperse. Hyperpigmented spots will begin to rise to the surface of your skin and eventually flake off, leaving you with a much more consistent, smooth, and overall more youthful-looking face.
While many patients will only require the one single course of IPL® photofacial treatment, other patients may need as many as three if they’re to fully reach their desired results.IPL® photofacial benefits include:
Treats a range of areas including the face, neck, chest, arms, legs, and shouldersMinimal downtime and recoveryHelps reverse signs of sun damageAddresses hyperpigmentation and acne scarsTreats skin rednessHelps prevent future signs of aging, according to recent research