What's the Best Way to Get Rid of Age Spots on Asian or Ethnic Skin?

Indeed most lasers are potentially harmful to darker skin. Skin coloration and age spots are made of a pigment called melanin. Melanin tends to absorb laser energy very easily. So patients who have more melanin (hence darker skin tone) will absorb more of the laser energy than those with very fair skin. 

This can pose the risk of overheating and scarring, which develops as a result.


However, there are some lasers that use very specific wavelengths which are relatively more resistant to being absorbed by melanin in the surrounding areas. They will target the problematic melanin in age spots, but not so much the melanin that gives your skin its color.


Fraxel Dual is an example of a laser that is actually very safe for ethnic skin. It uses the 1550nm wavelength and the 1927nm wavelength. When addressing age spots the 1550nm wavelength will break up the organelles in your skin containing the melanin.

And the remains are carried away by your lymphatic system. Here is a video of an Asian patient who underwent Fraxel Dual.

 

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your photo. I would use the Picoway Resolve on your skin to fair on the safe side. We do have a microfractional Co2 Laser which is lesser invasive than the fractional laser, but should require an in person consultation.  All the best.

Thank you for your question.  CO2 laser skin resurfacing treatment is very beneficial for making acne scars diminish, removing age spots, increases collagen and elasticity production.  This is done by removing deeper layers of damaged skin and stimulating the regeneration of healthy skin underneath. This treatment is also beneficial for uneven pigmentation, photodamage, fine lines and wrinkles, precancerous spots, and a host of other skin imperfections and benign lesions. If you believe you may be a candidate for CO2 laser skin resurfacing treatment, a qualified cosmetic surgeon or dermatologist can carefully analyze your skin and determine if the procedure is right for you

Treating age or sun damage on Ethnic Skin can be tricky because IPL/BBL lasers can make it worse, these type of laser's pick up pigment in the skin and can not differentiate between your natural pigment and a sun spot, risking burn's or hypo-pigmentation (white spots).  We always pre-treat our ethnic skin patients with a 4% Hydroquinone topical cream for at least 4 weeks to settle down the pigment cells.    My preferred method is using pro-fractional treatment laser for this pigment.   If the spots are resistant to that treatment we do use BBL laser's at very low settings for multiple treatments to get improvement.  Remember with any laser you are at risk for Hypo-pigmentation problems.  

In removal of dark spots for Asian patients, the choice of a treating physician is the key. Treating Asian patients are a challenge as there is hesitation about downtime and concerns about hyperpigmentation, hypopigmentation, hypertrophic scars are a concern. Broad Band Light applied properly in a series of four to 6 full face treatments may be useful. The proper use of a good medical grade such as Obagi may also be useful. Consult with 3 experienced and expert board certified physicians to understand your options.

As you pointed out, treating ethnic skin is a challenge as potential side effects are more common and can be significant. There should be a strict pre and post treatment care, specially after light base treatment such as laser, to avoid common problem such as post inflammatory hyperpigmentation.  In our experience, a carefully designed combination treatment that typically involves topical treatment (e.g. hydroquinone, tretinoin), IPL with very conservative settings, and light chemical peels.  It is very important, again, to adhere to strict pre and post care.  Lastly,each patient's treatment should be specifically designed for that individual patient based on skin tone, age, etc..  Good luck!

Creams such as retinoids (Retin A, Differin and Tazarac) may be mildly helpful for age spots. However, use of lasers such as Medlite or Ruby in non-summer months with appropriate preparation and precaution are usually the most effective.

In my recent interviews, I have discussed this topic as well as other age related skin rejuvenation methods/treatments.


Please refer to my recent articles:

Don’t Let Age Spots Show Your Age

Which Age-Defying Method Is Right for You?

How to look your best during each decade of your life

 

As an Asian dermatologist I see lots of cases like yours on a daily basis (up to 5 per day). As everyone has said, treating skin of colour is super tricky, as post inflammatory hyperpigmentation can easily occur. I myself had fractional laser around my eyes and developed PIH for several weeks. (My fault for not using sunscreen 2-3 times per day). OK - here is my tip1. Q switch lasers are great in fair skin types, you can get away with 532 QSL, but you MUST use sunscreen and bleaching creams after. 2. For a safer approach I would recommend the following (usually my standard treatment)- Fraxel 1927, conservative type 4 settings (less passes, lower energy) - up to 4 treatments, 6 weeks apart. Add Lytera and HQ 4% between treatments, and sunscreen. 3. Low strength TCA peels can be done 8-12%, multiple treatments. 4. IPL can be done - once again conservative settings. Combine this with HQ and Lytera +/- Vitamin A cream. Essentially an assessment needs to be conducted prior to treatment. I usually go thru life style factors, including your sun exposure on a daily and recreation basis. Treating Asian skin can be difficult, but slow and steady is the key. RegardsDr Davin Lim Laser DermatologistBrisbane, Australiawestderm.com.au 

One of the most effective ways to reverse the effects of age spots and chronic sun damage on ethnic skin is by using a combination of two prescription strength medications: tretinoin cream and 4% hydroquinone. Unlike the unsubstantiated claims made by over-the-counter skin care products, the results of using these creams are backed by real medical science. More aggressive treatments such as lasers in ethnic skin are more of a risk to cause increased pigmentation. We recommend the Obagi Nu-Derm System which uses both tretinoin cream and hydroquinone to visibly lighten age spots as well as the fine lines and wrinkles that are due to chronic sun exposure.