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How to choose the best laser to treat spots

Posted January 24, 2013 under Tools of the Trade - No comments

Treating hyperpigmentation can be very tricky, especially with lasers. Although lasers can help, they can also make it worse. The secret is to know what is causing the skin to have the darkness before you choose a laser.

Dr. Sinclair's Response

 Dark areas on your skin can be very unsightly and tough to treat. Most people are aware that sun exposure can injure your skin and cause dark spots to appear. But did you know that there many other causes? Knowing what causes your dark spots is absolutely critical when you are trying choose a treatment. If you choose the wrong treatment, you can make it worse!

Pregnancy frequently causes a brown mask like facial discoloration called melasma or chloasma.The forehead is the most common area to see melasma, but the entire face can be affected. A similar problem can happen with birth control pills.

Patients with darker skin types can be very susceptible to hyperpigmentation (brown spots or discoloration), especially from laser treatments. Although lasers can be used to attack the dark areas, dark skin can react by making even more pigment which causes the spots to get even darker. For this reason, lasers are usually a poor choice to treat dark spots on Hispanics, Asians, and African Americans.

Circles under the eyes can look dark, but don't be fooled. Sometimes the darkness is caused by thin skin which allows light to penetrate into the area and get absorbed by blood vessels underneath the skin. Since less light comes out, the area looks dark, but the problem is thin skin, not darkened skin. Other times, those same blood vessels can leak tiny amounts of blood very slowly. The blood breaks down and stains the skin with the breakdown product called hemosiderin.

To make matters even more complicated, not all brown spots have pigment. Some brown lesions have very little pigment at all. Their structure makes them brown, not pigment. Using a laser designed to get rid of pigment on these lesions is a waste of time and money.

So how do you choose which laser is best to help you treat hyperpigmentation? First you have to understand that if the doctor only has one laser, the chances are he will try to use it "to see if it helps". If the only tool you have is a hammer, everything gets treated like a nail! That can lead to very bad results. Find a doctor with lots of experience treating hyperpigmentation. Ask him to explain to you what is causing your dark skin and treat the cause. If your not sure he is giving you the right answer, get a second opinion before you get treatment!

If you normally have light skin and now you have dark spots that are not caused by hormones, then IPL (Intense Pulsed Light) may work great. IPL is technically not a laser, but even so, a good IPL can work wonders for dark pigment on light skin.

If you have thin skin under the eyes then a combination of fillers and a fractional resurfacing laser (Erbium or CO2) can thicken the skin and reduce the darkness.

If you have non pigmented lesions, then a Fractional CO2 laser can make some dramatic improvements.

Finally, if your skin is normally dark (Hispanic, Asian or African American) your best bet may be to skip the lasers and go for chemicals that lighten the skin.

Age Spots West Palm Beach



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