Our last post (Hyperpigmentation Part II) focused on prescription creams that reduce dark spots. Although these creams are extremely effective, they do take months to see final results. To accelerate dark spot removal, we can turn to elective in-office procedures.
IPL stands for Intense Pulsed Light. It is often referred to as a laser, which is a misnomer, since IPL uses bright flash lamps, rather than isolated beams of laser light. IPL is very effective at removing brown spots like freckles and sun spots, however it is not safe for anyone with tan skin because the device cannot differentiate between the melanin in a dark spot and the baseline melanin that makes up someone’s skin color. Due to this limitation, many offices have shied away from using IPL in recent years, or sold off their devices.
Whereas topical therapies such as retinoid creams can be very slow-acting, chemical peels rapidly lift all types of hyperpigmentation in a matter of days, including freckles, sun spots, melasma, and post-inflammatory hyperpigmentation from acne scars. Chemical peels can also be tailored to be safe on all skin colors, and they can be used all over the body- including the chest, arms, legs, and back. Unlike IPL which is better for “spot treatments” and cannot evenly treat large areas of skin, chemical peels can be spread evenly over large stretches of skin. It is important to recognize, however, that the results of peels completely depend on the frequency and quality of topical skincare (See our past posts for more on this) used before and after treatment. If your provider does not have a thorough discussion with you about pre-care and after-care, this is probably a red-flag that they do not have a deep knowledge of how the peeling process works. Peels also have the added benefit of inducing the repair mechanisms of the epidermis and dermis, resulting in brighter, thicker, more overall glowing skin. Our favorite Peel is Revepeel because it is the safest for all skin colors. ViPeel is another effective, commonly used peel.
Although chemical peels and IPL have been in use for decades, only recently has microneedling been studied as a way to remove pigmentation. About 6 clinical studies since 2011 have shown the benefits of microneedling, and that these benefits are augmented when used in conjunction with excellent pre-care and after-care, or when alternated with chemical peels. In particular, microneedling is a very safe technique for dark skin types, where risk of side effects is very high with techniques that are light or laser-based. Some of the most commonly used microneedling devices include: MDPen, Skin Stylus, and Skin Pen.