Pigment comes in many forms so it must be treated by a doctor familiar with the causes and modes of treatment. Not all lasers are the same. For ethnic skin such as Hispanic, Asian and African American with pigment problems, a laser which is color blind should be used. IPL becomes hazardous because it uses light that can burn and hyper pigment the skin even further. A CO2 laser can produce hypopigmentation as well as hyperpigmentation when used in the wrong patient and in the wrong settings (strength of beam) for ethnic skin. Some patients need repetitive treatment to achieve good results with melasma because this is a hormonal issue set deeper in the skin. Others may have large count of pigment cells called melanocytes, that take multiple treatments to eradicate. Prior treatments to attempt removing pigment may have damaged further the color of the skin making the problem worse off than it was. There’s a condition called Ochrynosis which imparts a black blue color to areas treated with bleeching agents for prolonged period of time. Only the natural alternatives for pigment may be used for prolonged treatment but these are weak agents that often leave expectations short.
At our office the doctor will manage your pigment with the right combination, for realistic expectations and will give you a true, honest evaluation so you can understand what particular form of skin damage has affected you. If blood work needs to be done for a hormonal evaluation that may signal a systemic disease such as diabetes, menopause, pituitary disorders, adrenal disease and others, you will be referred for such evaluation within our practice. We practice beauty and medicine for your best outcome.