A: There are many options because there are so many variables in hyperpigmentation that you really need a board certified dermatologist to walk you through the options to find the best for your needs.
The choices that I make for young patients are very different from older patients. Some patients can afford “downtime” from work or school, so I can do one treatment that is more aggressive and will give more dramatic improvement for severe discoloration. Others prefer the gradual improvement obtained from less aggressive treatments over several months that translate into no absence from work, school or their social schedule. Some patients have more sensitive skin or allergies, dictating I take a different course. Other patients also have other cosmetic concerns, and I will suggest a treatment that has multiple benefits. The ethnicity and skin type of the patient is most important since some procedures are preferred in skin of color. Only an experienced board certified dermatologist who provides ALL the options at her office can give you the best plan for you.
Let’s walk through some popular options:
Silkpeel Dermal Infusion is a new generation “microdermabrasion: system that requires 3-8 sessions 1-2 times per month to improve skin color and texture. It is best for younger patients who have less severe pigmentation. Since the cost is hundreds, not thousands of dollars and it can be paid as you go, it is a great option for someone on a budget. While the skin surface is mechanically exfoliated by the tip, the suction infuses special nutrients or exfoliates to deeply clean and renews the skin, brightening it with each session. It is painless as well and no dead skin comes off days later, so it is the ultimate “no downtime” procedure.
Chemical peels are not new, but remain an option to treat sun damaged, discolored skin. Intense Pulsed Light is newer and a better option for sun damaged skin in fair skin patients, but is usually not the best option for ethnic skin. By far the gold standard now for sun-damaged, discolored skin is the Fraxel Dual, especially if you also have acne scars and/or aging lines. The Fraxel Dual (and remember, not all fractional lasers are the FRAXEL) can be used on almost all skin types and the settings can be varied to improve texture as well as color. Fraxel even helps eliminate pre-cancers called actinic keratosis. Depending on the aggressiveness of settings, the downtime can be 2-7 days of swelling and flaking. It is truly important to have a board certified dermatologist direct your FRAXEL care and determine the settings for optimal results
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