I had IPL which worsened melasma and hyperpigmentation. Will Picosure/Enlighten help?

Thank you for your question! Melasma and hyperpigmentation can effectively be reduced with Pico Genesis. Pico Genesis uses the Enlighten Nd:YAG 1064nm laser which is safe for all skin tones. This laser works by shattering benign pigmented lesions. Chemical peels are also a great option for reducing melasma and hyperpigmentation. This exfoliates the top layers of the epidermis while stimulating collagen production.

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

No photos were provided, so specific recommendations are not possible. However, in general, so-called light, and relatively expensive laser and other energy-based treatments are backed far more by device manufacturer hype and social media influencer misinformation than hard science. So, going forward you might wish to consider some more conventional, less expensive approaches to treating melasma. These include certain prescription topical medications accomapanied by a series of in-office superficial peels, such as with high concentrations of salicylic acid or glycolic acid, Jessner's solution, or low concentration TCA. Manually performed (no need for extra expense and risks of added RF) microneedling may also be combined with the above. All of the aforementioned have a real track record to support their use. Finally, the added and offlabel use of topical and oral tranexamic acid can be considered, as well. And once again, a healthy dose of "buyer beware" is strongly recommended when evaluating so many of the expensive supposedly "new and improved" bells and whistles aesthetic devices are being hawked to you. Hope this helps and best of luck.