Our expert says:
Thank you for the question.
This is a difficult question to answer over the net as
ideally one would like to examine the face and the pigmentation before deciding
on the best treatment options. Considering you saw your dermatologist we can
safely presume that the spots are pigmented lesions, but we can’t be sure if
the cause is UV damage or hormonally induced also known as melasma.
When choosing a laser for pigmentation your best approach
would be to consider a fractional skin resurfacing laser. There are numerous
brands and lasers that offer this form of treatment (the most common is CO2, Q-switched
Nd:YAG, Q-switched alexandrite, pulsed dye laser, etc.), but results will be
dependent on the setting used and on the operator. The concern with laser is
that melasma may not improve as this is a difficult form of hyperpigmentation
to correct and some patients will not respond at all. Furthermore, possible
side effects do include a worsening of the pigmentation or a prolonged
Dermapen MD has also shown good results with hyperpigmentation
especially when a topical retinol is applied at the time of the treatment
followed by other topical depigmenting ingredients once the healing has
completed such as regular daily sunscreen, Vitamin C (in the mornings), Vitamin
A or retinol (in the evenings), arbutin, kojic acid, etc.
There are numerous non-surgical approaches to reduce small
pockets of fat including freezing and ultrasound. Both techniques work well but
similarly to the laser, results are dependent on the machine used, the settings
and the operator.
I hope the above has helped
Dr Alek Nikolic
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