I have black spots, hyperpigmentation from acne. They haven't responded to peels or hydroquinone or Triluma. I am thinking of having laser treatments. Which between Mixto, Fraxel Repair, or Fraxel Restore can help best with these spots? Or would you instead recommend Medlite C6 or Ruby type lasers, which are for pigments, than going in for Mixto or Fraxel? I appreciate your help, thanks.
Mixto Laser Vs Fraxel Restore or Repair for Dark Spots?
Doctor Answers 3
Nothing better for hyperpigmentation than the 1927 Fraxel Dual
I think that using CO2 for hyperpigmentation is overkill. The new 1927 laser of the Fraxel Dual is a very safe and effective laser for pigmentation. It is sort of a blend between ablative and non ablative.
It is very superficial, about 0.2mm and creates a sort of biologic dressing as the skin heals. There is no dressing changes. Some peeling occurs about 2-5 days later and that takes off the pigment. You might need 2 or 3, but it's very easy to handle.
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Laser Management of Pigmentation
I know this can be a frustrating issue, to have 'marks' once the acne itself has cleared.
There are a number of ways this can be treated but you should probably begin slowly.
The reason most people get the discoloration is because their pigment cells are highly activated during the healing process of the acne lesion. This most frequently occurs with darker complected people.
Many of the laser treatments to resolve this are ablative and therefore, you are actually re-injuring the skin which could possibly re-activate more pigment response. In essence, you could make things worse.
Any of the lasers, including a 755 alexandrite qs, could be benefiical or harmful.
Several suggestions: go to an office that works with a variety of lasers and thereby would be able to try several different options if needed; check out their credentials and find out how long they have been working with laser therapy; discuss doing test spots to evaluate the effectiveness and rule out any possible worsening and discuss with them about using a bleaching cream before and after the treatment to help reduce this pigment response.
Go slowly. It is better to do test spots, if needed, for several visits than to make the situation worse.
Hyperpigmentation from acne
For this condition, I have found that using a combination of q-switched alexandrite with Fraxel repair or restore is best. You may only need one treatment, depending on the severity of your condition. Best, Dr. Groff
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