Freckle/Pigment Removal for Arms on pale skin - IPL, PicoSure, Q-Switch, Fraxel CO2, peels? Quickest and most effective option?

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

Hi h.w,

Thank you for your question, it sounds like you’ve done lots of research. For the quickest most effective option I would recommend the Picosure.

Thanks!
ACM.

sun damage is best treated with fraxel combined with BBL. I suggest you consult. I always tell those preventing and treating you will need treatments every 2-3 months forever. skincare and sunprotection daily.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation, I would suggest a combination approach of
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

IPL/BBL is a good option with lower risk. Settings can be increased with repeat sessions monthly. The Palomar Max G is a good example.

Picosecond lasers are also a good option but typically at much higher cost.

Chemical peels carry a higher risk and not likely best choice.

An IPL treatment is a wonderful option for eliminating hyperpigmentation spots and involves no downtime. The only post-procedure issue you may experience is redness. Because there is no major resurfacing happening, like a laser, the different light wavelengths are gentle.

The hyperpigmentation is treated with powerful flashes of light in short, bursts. The energy created by the light penetrates the dermal layers below the skin’s surface and begins to address the melanin that’s causing the spots. The heat penetrates and attacks the pigment particles, which are broken down and then rise to the surface. They slough off or are carried in the lymph and eliminated naturally by the body.

If you have minor hyperpigmentation, results may be seen after one session. With more advanced hyperpigmentation, five sessions is the recommended succession.