Brown Spots and Hyperpigmentation – Bentkover Facial Plastic Surgery and Laser Center

We offer several types of treatment for unwanted pigment on your face, chest, hands, arms, legs, and neck...

Conditions we treat...

Brown Discoloration of the face, hands, chest, arms, and legs caused by aging and sun damage,,,also called solar lentigos
Diffuse brown discoloration of the face and neck from sun exposure...also called hyperpigmentation or dyschromia
Melasma...sometimes called the "mask of pregnancy"

A number of different treatment choices are available, depending on the cause and severity of the pigment...

Non-Surgical Skin Treatment Programs

Obagi NU-Derm and C-Rx Skin Treatment Programs (Face, neck and chest only).
- Lighten, recondition and remoisturize your skin.
- Skin treatment programs supervised by our aesthetic nurse.
- You do the treatment at home.
- Requires a commitment to consistnet and regualar use of the products.

Office Procedures

Portrait PSR³ Plasma Skin Rejuvenation
- Our BEST and most comprehensive treatment for unwanted pigment
- Also tightens skin and removes many fines lines and wrinkles
- New, lighter skin with often remarkable textural changes
- One treatment or multiple treatments in our office, depending on how dark your skin type
Candela IPL (Intense Pulsed Light)
- Removes many unwanted Brown Discoloration in a few short office treatments
Palomar YAG 5 Laser and Candela AlexLazr®
- Good for treating a few individual large Brown Discoloration (often called solar lentigos)

Since we offer many different ways to treat unwanted pigment we strongly suggest a consultation with Dr. Bentkover or our aesthetic nurse to see which approach is best for you.

THE DETAILS OF EACH TREATMENT

Obagi® Skin Care

If you have diffuse excess pigment of your face (hyperpigmentation) or Melasma (the "mask of pregnancy") that never clears, you will probably be well served by treatment with Obagi Nu-Derm® or Obagi C-Rx®. We often recommend these treatments with or instead of one of our machines described above. These are skin treatment programs that you do at home under the supervision of our aesthetic nurse. Obagi® products are well recognized world-wide for their effectiveness in rejuvenation of the skin from the bottom up. Improvement in uniformity of color, moisture and clarity are the principle goals of the Obagi® systems. They will rejuvenate your skin, leaving you with a healthier skin. Results are often dramatic. Please see the Skin Treatments section of this website for a more thorough discussion of the Obagi® Skin Care programs

We often combine lasers or Portrait PSR³ Plasma Skin Rejuvenation, IPL or a laser with one of the Obagi® systems after the initial treatment to insure on-going protection of your skin and further rejuvenation from the bottom up.

Portrait PSR³ Plasma Skin Rejuvenation

Our newest technology!
Removes Brown Discoloration and some benign skin lesions

Also...

Removes or improves wrinkles of the face
Renews your skin and promotes growth of new, smoother, healthier skin
Improves the appearance of acne scars
Stimulates true new collageg growth for up to 1 year after the procedure - longer than with the carbon dioxide laser
An office treatment with topical and local anesthesia

A major advantage of Portrait PSR³ Plasma Skin Rejuvenation is that we can treat large areas on your face for pigment and wrinkles at the same time with minimal down time. Portrait PSR³ Plasma Skin Rejuvenation from Rhytec is a new technology that utilizes a nitrogen plasma spray instead of a laser (Plasma is an electrified gas that is the fourth state of matter - solid, liquid, gas, and plasma.) Portrait® requires only topical or local anesthesia. Some patients are treated in three short, low energy treatments; some patients are treated with one high energy treatment. The choice of type of treatment depends on the depth of your wrinkles, degree of hyperpigmentation and how much down time is reasonable for you.

Portrait® works by heating the deeper layer of the skin, the dermis. This heat stimulates new collagen growth, which, over time, leads to tightening of the skin. The upper layer of your skin (epidermis) and unwanted pigment generally peel off a few days after the treatment.

With Portrait PSR³ Plasma Skin Rejuvenation, we are now able to remove hyperpigmentation and rejuvenate your skin with same procedure

With no skin preparation
Very little down time
Little anesthesia
In an office procedure

Your skin will be red after the procedure, peel in few days and be largely free of significant redness in 10 days.

Intense Pulsed Light (IPL)

If you have over 50 Brown Discoloration on your face, neck, chest, hands, arms, or legs, it may not be practical to treat you with a laser. Lasers used for treating pigment typically deliver their light beams in a target ("spot size") of 2mm-6mm. a very small area. The Candela IPL (Intense Pulsed Light) delivers light to a much larger target area. Therefore, it is often more practical to use this machine in treating large areas with even hundreds or thousands of Brown Discoloration. Because an IPL delivers light that contains a number of different wavelengths (colors), it is a bit less specific than a laser and may require more treatments. Dr. Bentkover will carefully evaluate your skin and recommend the machine he thinks will give the best results. Sometimes he recommends a combination of one of the lasers and the IPL machine.

Lasers

The Palomar YAG5® laser is a low dose YAG laser that can be used at two separate wavelengths of color to help eliminate pigment in the skin related to sun damage (and for some tattoos). There is minimal down time with some mild redness, swelling and sometimes some crusting for a few days. The AlexLazr® has similar applications and effects. Both lasers are used in the office and require only topical or no anesthesia. They are best when used to treat large isolated Brown Discoloration on the face and small to moderate numbers of Brown Discoloration on the hands, arms, legs and chest.

Too many choices?

Depending on the degree of pigmentation and your personal goals, you may choose to "jump start" your skin rejuvenation and pigment removal with Portrait PSR³ Plasma Skin Rejuvenation, a series of IPL treatments, or one of our lasers before starting on an Obagi® program. Or...perhatps all you need is Portrait PSR³ Plasma Skin Rejuvenation or Obagi®

The best way to decide which of our treatments for unwanted pigment is best for you is a consultation.

Please call us at 508-363-6500

YOUR PROCEDURE

Technique

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.

Re-Treatment

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.

FAQ

How do I know if it is safe to laser a brown spot?

If Dr. Bentkover thinks a brown spot on your face that you want removed looks suspicious for a cancer or a pre-cancerous lesion, he will recommend that he biopsy the lesion before committing to a treatment plan.

Can you just get rid of all my brown spots?

We can eliminate many brown spots and lighten others, especially if they are fairly large. Numerous smaller spots are harder to see while lasering and might be better treated with Obagi Nu-Derm skin care or Portrait PSR³ Plasma Skin Rejuvenation. Dr. Bentkover will be happy to discuss Obagi or Rhytec with you if he thinks it will give you a better result than a laser. Also, we often combine laser, IPL treatments, or Portrait PSR³ Plasma Skin Rejuvenation treatments with long term Obagi use, especially on the chest.