What laser to use to remove dark freckles/age spot/sun damage? Is IPL best for freckle removal? (Photos)

From the very start of your question, "What laser to use...", rather than "Which treatments are best", it is clear that industry backed marketing hype for this or that laser or IPL device has worked its magic on you. The fact that you didn't like the way the laser healed the last time by leaving you with white spots in place of the darker ones should have sent off alarm bells. I personally have been very disappointed in IPLs, as well as relatively expensive laser treatments, including fraxels, finding them a whole lot more supported by device manufacturer backed marketing hype than hard science. Frankly, you are likely to do quite well with tried and true, relatively inexpensive treatments consisting of a series of superficial chemical peels (full strength glycolic acid, Jessner's solution, full strength salicylic acid or low strength (10-25%) TCA), which typically do not engender pigmentary problems in people of color coupled with the regular, at-home use of prescription bleaching creams containing such ingredients as hydroquinone, arbutin, kojic and glycerrhizic acid and sunscreens. Before pinning your hopes on the next highly touted, supposedly latest and greatest light or energy device, you would do well to seek consultation and treatment by a board certified aesthetic physician and be sure to ask to see his/her before and after photos. Best of luck to you. 

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
Realself100 Surgeon

Thank you for the pictures.  I believe the Picoway Tattoo Removal would serve well, along with microneedling/PRP to help minimize the appearance the spots.  You would need a series of treatments to see improvements; along with a post-maintenance program of Laser Genesis to help sustain results. Best wishes.

This is an excellent question, thank you for sharing. Based on your photos, you are an excellent candidate for a Halo laser treatment. Halo is a hybrid fractionated laser that is both ablative and non-ablative for a complete treatment of the skin. With just one Halo treatment, there is a visible reduction in brown spots, pore size and overall skin texture. What makes the Halo unique is that there is only 4-5 days of downtime, which is very minimal in contrast to other resurfacing lasers. Additionally, the Halo can reverse sun damage and reduce the appearance of fine lines and wrinkles. The Halo is also safe on most skin types, including Asian skin. After your Halo treatment, I recommend maintaining your results with photofacial treatments (Such as BBL or IPL). To learn more about these treatments, please consult with a board-certified specialist experienced with these procedures. 

Great question.  I love the Pico Way or Pico Resolve laser treatment for all skin types including Asian skin.  Sublative Fractional RF is another option as well as multiple monthly Clear & Brilliant treatments.Another option could be VI Peel Precision Plus chemical peels and/or multiple Vitalize or Rejuvenize peels by Skin Medica.I strongly recommend an at home regimen that includes hydroquinone Rx, Lytera Skin Brightening Cream twice daily, Sente' Dermal Repair Cream in the morning under sunscreen as well as Sente' BioComplete Serum in the evening.  My favorite sunscreen is mineral based and oil free with DNA Repair Enzymes called Elizabeth Arden Pro SPF 50+.Hope this helps.  Good luck.

I suggest a series of BBL treatments done by someone who has a lot of experience with Asian skin types.  The BBLs in combination with good skincare and mild chemical peels should clear up most of your brown spots.  I call this sequence of treatments the "GLOW" regimen.The next option I'd consider is a Fraxel treatment with the 1927 nm wavelength.Good luck!

Hello and thank you for your questions and pictures. It really helps!I have had great success using IPL for situations such as your. If you look at the link provided and go to the photo gallery case # 3088, this patient has your same skin type, concerns and shows a 6 month follow up.The down side of IPL is that you need multiple treatments. The upside is that the recovery process is easier in terms of recovery vs. a laser treatment. The adavatage of  a laser treatment is that the "spots" can be removed in one treatment. However, the recovery can be more obvious / longer. So, the choice is yours. Sincerely,Dr. K

We love fraxel as the gold standard treatment for brown spots on the face. you can combine with microneedling/PRP, tattoo lasers and others to get even more improvement.  Best, Dr. Emer.

Thank you for your question Ethorne. I understand your concern.
IPL is a great treatment for facial rejuvenation. For my patients I recommend an initial series of 6 monthly treatments followed by one maintenance treatment every 3 months thereafter. Q-switched lasers can also be used. Our patients very rarely have issues with their recovery after an IPL treatment. However I can see how a person would be concerned after reading stories online. Please consult with a doctor for specific recommendations. Good luck!

IPL is a very good modality for pigment removal however in Asian sometime the pigment is not just sun damage but a skin color irregularity in those cases pico technology laser might be more effective and safer. They are usually more expensive though. Good luck make sure you consult in person with an expert.