Persistent brown spots – especially the stubborn ones.

Dr. Irwin, I am having a series of 4 Fraxel Restore Dual treatments hoping to get rid of brown spots as well as improve the texture of my skin. One of the larger spots on my cheek has probably been there for 15 years; it seems to fade with each treatment (just completed the third 5 days ago)! If the fourth treatment does not entirely remove it, do you recommend a particular product for follow-up that might eliminate it? Thanks! Amy

Glad you asked this –  they can be particularly stubborn if they’ve been there awhile.   They literally have some roots if you look at them under the microscope!  There is no skincare cream or other product that will remove these deeper brown spots!!

I agree with you though, that for some of these, even the best laser treatments done in a series like you are doing with the Fraxel Dual system, can’t always get every brown spot gone permanently.   Especially for those that are darker or those that have been there for a long time.

Here are some options to discuss with your doctor.  Please only go to experts for this –  a board certified dermatologist or plastic surgeon who is onsite supervising closely or doing the treatment themselves.  These deeper brown spots need to be removed with another technique and then the laser done over the area to blend.

In our clinic, for example, we sometimes used liquid nitrogen first or more surgical removal with currettage and electrodessication (a special scraping tool with an electric “melting” tool) or even a shave excision.   These go deep enough to get the roots of the some of the deeper lesions.   The laser is then done over that either that day or a few weeks later to blend everything.  Other readers questions and answers on brown spots.

Hope this helps,   Dr. I

Dr. Brandith Irwin, MD

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