I've had Fraxel on my forearms to reduce sun damage as well as age spots (Photo)

Question

What would be the appropriate procedure to reduce spots? I've tried Retin A that only irrated the spots.

Raffy Karamanoukian, MD, FACS · Answer

I would start with an intense skin rejuvenation protocol for age spots that includes fractional laser, Covalent chemical peels, and daily skin brightening creams to improve your skin’s complexion. Laser therapy must be combined with a proper skin regimen to enhance and maintain youthful results.
The following skincare products for dark age spots: Melarase
MelaClenz Brightening CleanserMelarase AM: Day-time skin lightener with SPF 30Melarase PM: Night-time skin lightenerMelapads: Daily Exfoliating PadsReplenish Retinoid Cream: Exfoliating and skin-stimulating night creamBest, 
Dr. Karamanoukian
Realself100 Surgeon

Hooman Khorasani, MD · Answer

Thanks for the photos these are super helpful. First thing to start is that you are using a daily sun screen with SPF 30+ that has broad band coverage.  IPL is a good option  but is a jack of all trades and to some experts a master of none.  However other options include Clear+Brilliant and Fraxel Dual.  The Clear+Brilliant laser has minimal downtime and great results.  The laser has two hand pieces one for texture/pore size and one for color (pigmented spots)-Permea handpiece.   Fraxel Dual has a bit more associated effects with redness for 3-5 days.  Another issue is the cost of the procedure is bit more than Clear+Brilliant.  For the larger or darker spots you can consider doing something like an Alexandrite laser 755nm as Dr. Green mentioned the Trivantage.  Make sure to discuss these options with a board certified Dermatologist that has cosmetic training or uses these lasers on a regular frequency.  Thanks for the question, I hope this helps your decision making.

Jason Emer, MD · Answer

Sun damage and age spots will need life-long maintenance. A combination approach will give the most improvement long term with lasers (Fraxel, Tattoo lasers, Excel V, Pulsed Dye), peels and microneedling/prp. It may take a few treatments to get improvement and will need life-long treatments to maintain. See an expert. Best, Dr. Emer

Carmela A. Pettigrew, MD · Answer

An IPL/BBL treatment are very effective for reducing age spots and pigment on your arms, face, hands and chest. Most will need several treatments four to six weeks apart.  You should avoid sun exposure after or they will return.

Fereydoon S. Mahjouri, MD · Answer

An IPL treatment on the arms can be very effective for reducing age spots and pigment. Most people will need at least three treatments four to six weeks apart. Plan for the pigment to get darker before it lightens. Many people will plan treatments when they can wear long sleeves. You should avoid sun exposure after IPL treatments.

Laura Riehm, MD · Answer

Thanks for your question and posting pictures.  Fraxel has a couple of different modes.  The Fractional 1540 nm is really good for resurfacing texture, but really wouldn't be recommended for hyperpigmentation.  You have a lot of other treatment.  You will probably never be completely rid of them and they will probably always try to come back.  If you are a skin type I-III, an series of IPL photofacials may be helpful.  We have also been very successful using the PicoSure laser with the FOCUS and / or Flat Lenses eliminating hyperpigmentation with a series of treatments.  This laser is safe for all skin types.  Start with sunscreen every day!  Once you have treated your freckles to your satisfaction, you will probably need a follow treatment every 6 to 12 months depending your level of re-pigmentation.  Best of luck.

Michele S. Green, MD · Answer

When you have such extensive sun damage it usually takes a combination of treatments to help address this problem like Fraxel and the Alex-Trivantage.  Fraxel is amazing for large areas of hyperpigmentation.  For darker spots that are more dermal you will need "spot" treatment with the Alex-Trivantage laser. Please consult an expert in lasers and pigmentation for the best cosmetic results.  Best, Dr. Green

I've had Fraxel on my forearms to reduce sun damage as well as age spots (Photo)

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