The real story about Fraxel Re:pair

Joel Schlessinger, MD answers: Hypo-pigmentation After Fraxel Repair

I am 12 weeks post fraxel repair and still dealing with hyper-pigmentation issues that are slowly getting better. I recently got another opinion from another PS that is very experienced with CO2 lasers. I was there for another reason, so he was looking at my face with make-up; but, he said it looked like I was still dealing with some prolonged erythema and that the erythema could possibly lead to hypo-pigmentation. I understand that hypo-pigmentation is usually permanent. I am using Triluma for the hyper-pigmentation which tends to make my face more red. I'm so confused at this point. I do have some white patches that have been visible since the day after my treatment. I assumed they were areas that were skipped and never considered that they could be hypo-pigmented. Can hypo-pigmentation come on that fast? Should I lay off the Triluma until all of the redness goes away and then deal with the darker spots? While in the waiting room they had the Reliant video playing and it made my cringe. Their claims of "a few days of redness and no reports of delayed onset hypo-pigmentation" are ridiculous. There is no doubt I had some great improvement in some areas of my skin, but I feel like I traded them for other issues. I feel lucky that I didn't have more damage than I did.


Joel Schlessinger, MD
14 months ago

You have just found out the greatest lie in laser surgery and one that is unfortunately perpetrated by the laser companies to physicians and from physicians to patients.  It makes me mad as well when I see the laser information that states recovery is that quick.

It simply isn't that quick if the physician does the laser with the goal of improving your wrinkles.  If the recovery time is short, the results will be as well.  So, hopefully your results will be good since you are experiencing ongoing redness.  On the other hand, management of the problems after a laser procedure can be quite challenging and that is why, as a dermatologist, I feel that laser procedures are best performed by dermatologists rather than other specialties.  But, as a proviso, I also think that the dermatologist actually needs to be the one in their office that is actually doing the procedure as many of them pass it off to a PA or nurse. 

The summary of this question is: buyer beware!  Laser companies that promote lies about their equipment and recovery times won't get repeat business so it is important for the physicians to check out claims like this and go over a 'real' timetable of recovery with the patient before the procedure rather than waiting to see if the patient realizes that what they were told bears no resemblance to what actually occurs.

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