How to effectively remove sun freckles on forearm after trying hydroquinone? Persist w/ Rx creams or try Fraxel Dual/IPL?(photo)

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

With the amount of sun freckles on your arms I would recommend a treatment like an IPL or Fraxel 1927 laser. We get great results treating sunspots with our Fraxel 1927. You are doing the right thing by protecting your skin with a physical sunscreen just remember to reapply depending on the exposure time. I like to partner the use of Obagi products and laser treatments to help with hyperpigmention issues for my patients. I would recommend consulting with a qualified provider to go over your treatment options.  

With the extent of sun damage that you have I would definitely recommend the Fraxel Dual to treat your arms.  However, you have to be realistic since it would take at least three treatments spaced one month apart to improve this pigmentation.  Best, Dr. Green

Great question. Both the IPL Photoderm and the Fraxel Thulium (1927) wavelength work well for freckles and sun spots of the forearms. From the photos you provided, you are going to need  to do more than the Obagi products. I think that the combo of an IPL and the Fraxel 1927 would be a great option for you. I recommend getting a consult with a board certified dermatologist who to go over your options. 

I personally like the Fraxel 1927 for arms. Reason? Because we can blend - IPL may give you too good a result, leaving cut offs. If you have heavy damage, I usually use PULSE FRAXEL, i.e.. IPL first, followed by Fraxel. I usually wait 4-5 weeks, then re treat with Fraxel 1927 only. Blending in is the key, ie. less passes along the edges. All the bestDr Davin Lim Laser DermatologistBRISBANE, Australia.