Picosure for brown spots, sun damage - not working?

Question

I have had three Picosure treatments a month apart for facial brown spots. After each treatment, there is redness, and very minor swelling and discomfort, which disappear within 48 hours. Contrary to other posts I have read, the brown spots do not get a coffee-ground appearance or flake off. In fact, other spots I did not notice before have become more visible. Should I persist with this treatment?

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

Shim Ching, MD · Answer

I would discuss this with your treatment provider.  It would be helpful to compare your present situation to prior photographs or undergo some sort of skin analysis such as Visia to see if your spots have lightened.  If you did not experience any changes in the spots, you may need a higher treatment setting.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Who is doing this treatment? Picosure works extremely well, but is a complex laser to work, because one has to get the diagnosis correct before treating any 'brown'. At this moment in time, I do most of my Picosure pigment work, especially on darker skin types. The end points could be frosting (as you will see on the video), or excessive snapping. Usually pigment will be markedly reduced after 2 sessions. All the best,Dr Davin LimLaser and aesthetic dermatologistBRISBANE, Australia.

Picosure for brown spots, sun damage - not working?

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