A. Fraxel and TCA peels: I cannot see the need for that many TCA peels prior to a series of fraxel laser treatments. Sometimes I do combine other laser treatments with Fraxel in order to enhance results. Some examples of lasers used in combination with Fraxel are:
- Vbeam pulsed dye or Gentle YAG 1064 for bood vessels or redness
- GentleLase long pulse alexandrite or a q-switched alexandrite laser (ex: alex trivantage) to treat pigmented spots - freckles, melasma
- Smoothbeam non-ablative laser for depressed scars
Additionally, I commonly use 90% TCA to the base of ice pick type acne scars (CROSS technique) immediately prior to Fraxel to help with these difficult to treat deep scars.
B. Darkness after Fraxel: Even with olive skin, the risk of darkness or what is called medically PIH - post-inflammatory hyperpigmentation - is very rare even after moderately aggressive Fraxel treatments. If you aer concerned about PIH or have experienced darkening after skin wounding previously, then discuss with your physician adjusting the settings of Fraxel laser to minimize the risk of PIH. PIH is also very treatable if it does occur.
