Can someone please suggest the best treatment for hyperpigmentation and uneven skin tone?

Which IPL device was used?
There are many differences between the various IPL devices. Many people including operators working in the industry may be unaware of these differences.
Potential energy output, degree of contact cooling, pulse characteristics and wavelengths emitted are just some of the variables that need to be considered. In many devices there just isn’t enough energy available even at maximum settings. If there is inadequate cooling at the point where the device touches the skin then this will limit what can be safely and comfortably used. Delivering the energy using a single smooth top hat pulse is now safer and more comfortable than traditional spikes of several pulses. OPL standing for Optimised Pulsed light is where the manufacturer has removed those wavelengths that are unhelpful focusing the energy in those wavelengths that target pigment (and vessels) more effectively.
A simple question is whether you saw a response within the first days of treatment. Pigmentation must initially darken significantly or else it is unlikely to improve. This represents the damaged pigment cells changing colour and then working to the surface as the skin naturally turns over. If this pigment colour change did not occur then you may have been inadequately treated.
Dr Mervyn Patterson
Medical Aesthetic Doctor and Medical Director responsible for the distribution of the Palomar Starlux

Hi Ben,
The Obagi Nuderm system is fabulous for pigmentation and has always delivered fabulous results to my clients. The treatment regime does cause flaky inflammed skin initialy, but this does settle down after several weeks. You should only start this treatment after a consultation with an Obagi trained medical practitioner, who will give you support and advice through out the treatment.
In my clinic we also use the Dermaceutic spot peel for pigmentation, sometimes more than one treatment is needed to achieve clearance of the pigmentation. On rare occasions this peel has not fully removed the pigment, but in general our clients are very satisfied.
We also use an IPL system for removal of pigmentation, this usually gives fantastic results but occasionaly it is not effective.
Sun Protection should be used at all times, to prevent the pigment from getting worse and also it is very important to use it after treatments otherwise the pigment can come back.
I have not seen much of a result on pigment myself from the roller devices, I am aware they can help, but as our other treatments mentioned above are succesfull, we tend to reserve the use of rollers for treating scarring and wrinkles only.
If I was you I would book an appointment at a reputable clinic with a medical practitioner that offers a range of treatments, including the Obagi NuDerm System. Your pigment can be examined by the practitioner and then you can discuss the pros and cons of each treatment he or she recomends and the likelihood of success.

Hi Ben, By the sounds of it and without seeing you I would probably prescibe a series of skin peels strengh dependant on damage! I would consider Dermaroller in conjuction with the peels for optimum cellular turnover.
Hope this helps
Mark

I feel you will have more success with Chemical peel tretament compare to other treatments you are talking about.
My customers have been very happy using a product call Even Essence by Mary Kay. You have to use this serum with SPF built in moisturiser . It take over 6 months to see the results. If you are interested please contact me.

Hi Ben. Uneven skin tone and hyperpigmentation can be eliminated by chemical skin peels. Depending on your skin type, I would probably recommend a course of "medium" depth or Easy TCA skin peels with appropriately prescribed cosmeceutical creams to help blend away the hyperpigmented areas, in combination with a sunscreen (SPF 50). There is no discomfort with the peels. It's important that you have the spots/lesions evaluated by a medical professional before treatment to ensure there's nothing more to worry about, and all my treatments are offered after I've done a full medical assessment.
Dr Kim Thomas
Camomile Medical

First and foremost, you need to use sun protection dailey. Even on cloudy days. And, since you have tried laser treatments with minimal results, it sounds as though you will require an aggressive home care regime. Obagi comes to mind or the new Vi peel series. Both would need to be obtained thru a Medical Aesthetician via a Dermatology or Plastic Surgery practice. Do not attempt to try the Obagi products on your own without first seeking the expertise of a professional, for optimul results.
Remember: It took years of sun exposure for you to have the level of sun damage that you presently have. Change will not happen overnite. You will need to begin a regime and be consistent with the protocol. And, always wear sun protection or you will be wasting your time, money and effort.

Hi there Dermaroller tends to be really helpful with this. A dermaroller is a device with hundreds of small medical grade microneedles arranged around a medical roller device. As the dermaroller is passed across the skin it causes small micro punctures in the skin surface. This controlled damage to the skin surface is not deep enough to elicit a scarring response however it will cause the body to have a milder healing response. The nearby tissue is broken down and new elastin and collagen are formed. This way scarring, lines, wrinkles and pigmentation are all gently removed, being replace over time with new scar free skin.
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