How to treat skin pigmentation

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How do I treat skin pigmentation? Skin pigmentation can be due to many factors including age, genetics (freckles and birthmarks), as well as sun spots, liver spots, and hormones such as melasma.

Skin pigmentation can be treated with creams, chemical peels, microdermabrasion, skin needling, microneedling, and of course lasers. The best laser is one that is tailored according to the type of skin pigmentation as well as the Skin Type or the ethnic origin of the patient. Here are some of the lasers is use to help remove skin pigmentation on the face, neck, décolletage, and hands.

Fraxel 1927- one of my all time favourite lasers for skin rejuvenation and pigment reduction. This laser can be safely used in all skin types. I often combine 1927 Fraxel with other lasers to achieve even better results.

Fraxel 1550- this wavelength enables me to treat pigmentation as well as provide collagen remodelling, reducing sun damage, wrinkles and acne scars.

Fraxel CO2- this Fraxel wavelength provides maximal collagen formation. Ideally suited for Queensland’s sun damage skin. Erases wrinkles and improves skin texture.

Picosure Focus- this fractional laser is suited for Asian and Ethnic skin types. It works extremely well for wrinkle and pigment reduction, skin rejuvenation, and the treatment of early acne scars. Best of all it has no downtime!

Revlite QSL- this laser is used to treat isolated freckles and spots, as well as treating hormonal pigmentation. I also use this a skin toning laser- however Picosure Focus is better for improving skin texture and tone.

Erbium ProFractional- I occasionally use this laser to treat darker skin types, however I have replaced this laser with Fraxel 1927 with low density CO2 Fractional Resurfacing. ProFractional is ideally suited for darker skin patients.

Erbium Fully Ablative- my favourite laser for treating extreme skin pigmentation due to sun damage, associated with severe wrinkling – ideally suited for patients over the age of 45. This gives amazing results, especially if combined with CO2 fractional resurfacing. Downtime is 7-10 days, depending on the depth, however only one treatment is needed.

CO2 Fully Ablative/ Fractional / Fraxel RePair– I use this laser to tighten skin, as well as reduce skin pigmentation. No other laser provides as much skin tightening as CO2. The downside is that it takes 5- 12 days to recover (depending on the settings) and redness may persist for a few months. I reserve this laser for treating pigmentation in association with wrinkles.

BBL or IPL- Intense Pulse Light is not a laser but an energy device. Most often used by cosmetic GPs and beauty salons, this is a good ‘all round’ device. I use IPL to reduce freckles on the face, chest, shoulders and arms. Best combined with Fraxel laser (called Pulse Fraxel), as in combination it can address pigmentation, as well as improve skin texture and tone.

V BEAM Pulse Dye Laser- I occasionally use this laser to treat brown spots – freckles in fair skin patients. This laser is primarily used to treat red skin conditions including rosacea, red blotch skin, and broken capillaries. Turning the skin cooling function off in this laser can help reduce freckles and sun damage.

IPL or BBL Intense Pulse Light- this is not a laser, but light that is concentrated to a particular wavelength. IPL has been around for nearly 2 decades, and it can be good treatment for treating brown and red skin pigmentation, including sun spots, liver spots, and freckles. Most patients require 2-3 treatments, however I often combine this with Fraxel (Pulse Fraxel skin laser rejuvenation- this means only one session is required).

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Dr Davin Lim
Laser and aesthetic dermatologist
Brisbane, Australia

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