What will help to remove my birthmark & surrounding hyperpigmentation? (Photo)

​Hyperpigmentation of any kind needs a combination approach of peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly,; lasers like Clear + Brilliant, Aerolase or Laser Genesis; radiofrequency like Venus Viva; and constant skin care and sun protection. Bimonthly facials with SilkPeel DermalInfusion are essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. If you have acne you can do additional treatments and peels to get more improvement. Hypopigmentation will need more of an evaluation and possibly additional lasers to get improvement. I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.​

You are quite on the mark with your concern that lasers may risk post-treatment darkening, especially in persons with skin of color. Professionally performed microneedling, since it is not light-energy based, poses much less risk of dyspigmentation, and I have personally used it for more than two decades safely and effectively in all skin types, including individuals with skin of color. Microneedling can be particularly effective lightening dark spots of all causes when accompanied by the topical application of prescription pigment lightening agents by enhancing their penetration. Make sure to consult with an experienced, board certified cosmetic dermatologist and be wary of venues heavily promoting the relatively expensive light or laser device that they have just purchased. Hope this helps. Best of luck.