White and brown sun spots on jaw and forehead from sun damage - What are my options? (photo)

Question

I have some sun damage from when I didn't take care of my skin when younger, in the form of white spots on my jaw & forehead (brown as well). For the brown spots, I use tazorac, I did a pico laser (3 treatments), I'm doing a ViPeel tomorrow. Is there anything more I can do to remove/reverse the white sun spots? Thank you in advance

Bhupendra C.K. Patel, MD, FRCS · Answer

You look like you can tan fairly easily (Fitzpatrick type 2 to 3 skin). The white spots are probably where you have had sunburns in the past: these cause you to lose melanin in these areas, hence the white spots. The rest of your face on the photograph shows changes which look like melasma. A combination of a picosecond laser and the aerolase laser administered over time gives the best results. These treatments will not give you pigmentation back in your "white" spots, but the spots will look more blended in when the rest of the skin color improves with these lasers. Be very careful not to have traditional IPL as that can make your melasma-like pigmentation worse. 
Tazorac in skin like yours may cause some irritation which can cause hyperpigmentation. You may want to monitor the effect of the Tazorac on your skin closely with the help of whoever prescribed it to you.

Raffy Karamanoukian, MD, FACS · Answer

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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

White and brown sun spots on jaw and forehead from sun damage - What are my options? (photo)

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