Brown Spots

Type 4 skin before Obagi NuDerm


Obagi NU-Derm and Obagi C-Rx

These prescription based skin treatment programs are supervised by our aesthetic nurse.  Success in these programs requires patience and commitment, but the results are well worth the effort and often amazing. (See Skin Treatments).

For the Candela IPL machine, a cool gel (called an optical coupler) is applied to the skin to improve the penetration of the beam and decrease pain. Generally, no topical anesthetic is needed. Your eyes will be protected with appropriate protective glasses or shields.

The length of treatment depends on the size of the area being treated.  Usually it is under 15 minutes. You will have redness and swelling after the procedure and ice will be applied immediately after the procedure. You should continue ice packs for 20 minutes every two hours while awake for the next 48 hours. As a general rule, the darker the pigment, the more the absorption of the light waves and the more swelling you can expect. The more you apply the ice, the quicker the swelling will subside.  Most redness usually resolves in 24-36 hours with conscientious application of ice. Larger areas of deeper pigment may remain slightly pink for 4-6 weeks and slowly fad away. With the IPL machine, your skin will take on a “dirty” look from 1-72 hours after treatment.  These “dirty” areas are where the pigment has absorbed the light.  They will peel or fade for a 7-10 day period.   You should not have any blisters or scabs. If you do, you should call us.

If you are having Portrait PSR3 Plasma Skin Rejuvenation, there is no significant skin preparation. As a matter of fact, if you are on a retinol like Retin-A and Renova or any kind of frequent fruit acid treatments to your face (like glycolic acid or vitamin C) we will ask that you stop using these about 3 weeks before the procedure. The reason for this is that your epidermis acts as what is called a “biologic dressing” after the treatment, and these products thin the outer most layer of the epidermis, the stratum corneum.

Portrait PSR3 Plasma Skin Rejuvenation requires only a topical anesthesia for a low energy treatment and topical plus injected local anesthesia for a high energy treatment, even of the whole face. Low energy treatments are usually done in a series of 3 treatments, spaced 1 month apart. High energy treatments are usually a single treatment. After either procedure you will be asked to keep your face covered with a petroleum based product like Aquaphor. You may not wash your face for 24 hours. Depending on the level of energy delivered to your skin, you can expect to see your skin turn brown between 1 and 4 days after the procedure. This brown mask will slowly peel over a few days. After it is all peeled, you may return to you usual skin care except for the use of retinols and fruit acids like glycolic acid or vitamin C. You should avoid those products for another 2 weeks or so. You skin will continue to tighten for a year. Usually by 7-10 days after surgery the redness is gone.

For the YAG 5 Laser or AlexLazr, you may or may not choose to have a topical anesthetic.  Most patients find that a topical anesthetic is really not necessary when treating brown spots. (When using these lasers to treat tattoos, however, the treatment is more intense and we often use a topical anesthetic, ice, an injected anesthetic or a combination of these techniques.)  Your eyes will be protected with appropriate protective glasses or shields.


Many patients will require more than one laser or IPL treatment. It takes about 8-12 weeks to see the full effect of the lasers and 30 days for the IPL. We usually do follow up treatments at 8 week intervals for the lasers and 4 week intervals for the IPL. How many treatments you have is up to you and your aesthetic goals. No laser/IPL can clear every brown spot. The objective is to get to a point with which you are happy. Also, as already stated, some Rhytec procedures are done with 3-4 low energy treatments and some with a single high energy treatment.  After that it is up to you to protect you skin from the sun with SPF 30 or higher sun block to help prevent more pigmentation. We may recommend Obagi NU-Derm in maintenance doses to the face, neck or chest to help prevent the pigment from returning. .  



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