I have had the fraxel restore four times for my sun spots. My face still has it with 40% less than the initial. When I returned, the doctor said I have to wait two months befor it takes its affect. So, is the doctor telling the truth or is she conning me? Are the treatments to fix the sun spot or will melasma disappear?
Fraxel Re : Store
Doctor Answers 4
Fraxel Re:Store and Melasma
Make sure your doctor has the Fraxel Re:Store Dual laser which has an additional wavelength. In addition to the standard Erbium wavelength (1550 nm), the Fraxel Re:Store Dual has a more superficial Thulium wavelength (1927 nm). The additional wavelength is much more effective in treating dyschromia (skin discoloration). It is especially effective in treating brown discoloration such as melasma.
Additionally, melasma, even when effectively treated, can reoccur with sun exposure and hormone use. Estrogen containing medications, such as certain birth control pills or hormone replacement therapy, can cause melasma to occur or worsen. Sun exposure will also increase brownish discoloration in the skin. It is imperative to use an excellent sun blocking cream with UV-A, UV-B, and UV-C protection.
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Combination Therapy in Treatment of Melasma and Sun Damage
In my experience, Fraxel re:store is most effective in the treatment of depressed acne scarring. I have used it on occasion for hyperpigmentation and melasma, but I have found it not to be appropriate as a treatment for everyone. The first factor to consider is the nature of your pigmentation; is it truly melasma, or is it sun damage? At this time there is no cure for melasma, and I have found it is a combination of therapies (lasers combined with corrective skincare programs and proper sunscreen use) to be the most effective treatment. If the pigmentation is sun damage, I often use a light-based technology called Intense Pulsed Light, as it targets the areas of pigmentation and creates a more even complexion. Consult with an experienced Cosmetic Dermatologist in your area to first determine the proper diagnosis, and the corresponding treatment that would be best for your particular skin condition.
Fraxel Restore effective for brown spots
Fraxel Restore is very effective for sun spots or lentigines. Melasma, on the other hand, is very difficult to improve. Over the years, physicians have used chemical peels, intense pulsed light, bleaching cream, and lasers to improve Melasma. Melasma tends to come back if one does not follow a strict regimen of sun protection and bleaching cream before and after treatments.
I have had the most success with Fraxel restore for Melasma. However, each patient's response is very different-- while most patients have terrific improvements, others may have only modest improvement with treatment. The amount of improvement depends on many factors including a patient's skin type (one has to be less aggressive with darker skin and even asian skin), sun exposure after treatment, their initial skin tone, the laser settings used etc. Without seeing your before and after photo, it is difficult to judge whether you have achieved optimal improvement. It is also important to distinguish which areas are sun spots and which are melasma (since melasma areas are more stubborn). I agree with your doctor to wait a few months before any additional treatment. I would also advocate using sun protection daily and consider a bleaching cream (hydroquinone) to reduce any additional pigmentation.
Dr. Margaret Mann
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Fraxel restore and Brown Spot Treatment
Fraxel restore will help with brown spots from the sun. It is important to protect your skin from the sun with sun block, clothing, and avoidance, especially with melasma. Fraxel Dual is very effective at treating brown spots and is among the best laser treatments for melasma. Good luck and be well.