Springfield Dermatologists

Can Someone Please Tell Me What I Should Pretreat with Before Fraxel?

I want to do a series of Fraxel treatments. I can't do the Fraxel dual because I think I will hyperpigment. I previously used Meladerm with Kojic acid. I am now using Lumixyl. I can't use Hydroquinone. My skin is too sensitive. Which pre and post treatment cream will help prevent PIH ? which cream is stronger - Lumixyl or Meladerm (with Kojic Acid) ? I have Melasma on my upper lip. I want to treat this with the Thulium Fraxel alone. What settings should I use ? skin type 3

Post-inflammatory hyperpigmentation risks are real after ablative and non-ablative fractionated procedures, particularly in type 3 skin.  The risks are much less than with peeling agents, but cannot be always be avoided even with the best regimens.  I see no problem in using Lumixyl and Kojic Acid as they have the same effect but work differently.  Sun protection through physical blockers should be paramount in your regimen for 2 weeks before and 6 weeks after the procedure.  Either of the anti-PIH creams you are using could be part of a longer-term strategy for you, like for 6 months following the procedure. 

Michael Howard Swann, MD

Springfield Dermatologic Surgeon

What Are the Side Effects of Smartxide Dot Laser?

What complications can you get after smartxide dot laser ablation.

Complications will include pinpoint bleeding and burning pain which both resolve quickly after the procedure.  After an aggressive treatment with the DOT fractionated CO2 laser, you should expect to be beet red for 5 days, then light red/pink for another week.  You will keep some pink color to your skin during collagen remodeling, which takes place for a few months afterwards.

My patients wear breathable makeup on day 6 or 7 followed by their own makeup at day 12-14.  Sunscreen is essential for 4-6 weeks after treatment for great results.

Michael Howard Swann, MD

Springfield Dermatologic Surgeon

I Am Having Mohs on my Left Cheek 1.5 Cm and Want to Try and Heal Naturally is This Ok?

I am having Mohs on my left cheek 1.5 cm and want to try and heal naturally is this ok? 

There are certain anatomic locations where leaving the tissue defect to heal in after Mohs is actually cosmetically superior to suturing the wound closed with a flap or skin graft.  However, this is generally reserved for concave locations like the inner canthus or ear rather than the cheek.  Generally cheeks heal best when they are appropriately closed with suture.  They heal the fastest and also leave the nicest cosmetic result.

Michael Howard Swann, MD

Springfield Dermatologic Surgeon