Skin that look dirty and patchy - what treatment should I do? (photos)

Question

Hello Almighty doctor .. I would like an advise for 45 yrs old asian skin. I been on pico for 6 section within 3 month n also have restylane for 3 time after pico section, my skin still have patchy spot n really small tiny bump to make overall skin look dirty, what treatment should I be using ? Many thanks in advance, will be in Nyc In june for 3 month n like to explore good doctor to give me a smooth skin

Jennifer Reichel, MD · Answer

Hi.  From the photos, I would recommend a resurfacing procedure or series of procedures. My favorite resurfacing lasers for you are Halo and Fraxel. Both of these devices use a "rolling" technology, rather than a "stamp". The paintbrush style of these lasers won't leave small squares or dots on your skin like other resurfacing lasers.  You may need a series of treatments. 
There is a small risk of PIH (post inflammatory hyperpigmentation) in asian skin. Consider pre-treating with hydroquinone. 
I also think you should be on tretinoin for maintenance for the pigment and texture!!

Good luck.

Jason Emer, MD · Answer

Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​

Skin that look dirty and patchy - what treatment should I do? (photos)

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Skin that look dirty and patchy - what treatment should I do? (photos)

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