I have a Indian Skin, I have Deep Pitted Acne Scars. I do not have Fraxel Repair available in my city or in my country If I wish to go for the Fraxel Restore and If I start with a Higher Preset from my first session i.e 70mj are there any chances of Hyper-Pigmentation on my skin because of using a higher preset. Plus I have a very sensitive skin. But without having a Higher Preset my scars will not respond as they are that deep.
High Risk of Hyperpigmentation with Fraxel Restore on Indian Skin?
Doctor Answers 3
Fraxel Dual for Darker Skin Tones
Fraxel Dual is safe for all skin colors. Here is the reason why. It uses the 1550nm and the 1927nm wavelengths, which are not easily absorbed by the melanin levels in your skin. In other words, it just does the job of inducing normal and healthy collagen fibers to develop by penetrating the skin at deeper levels. This is how acne scars are reduced (replacing scar tissue with new collagen). The risk of Fraxel restore lasers on dark skin comes from the high levels of melanin which causes you to take in higher levels of laser energy, above the safety threshold. Since the top skin layers are not targeted, the hyperpigmentation is not addressed. However Fraxel Dual's superficial 1927nm wavelengths actively targets the top layers of the skin causing fractional resurfacing of that layer. The result is a reduced incident of hyperpigmentation. As a matter of fact the 1927 component is FDA approved for treating age spots. Thus Fraxel restore 1550nm targets collagen in deep layers while Fraxel Dual's 1927 targets the top layers removing age spots and other dark pigments in the process.
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If you have dark skin, Fraxel is a higher risk for you. It will help your scars, but may hyperpigment you as well.
Hyperpigmentation from Fraxel is a risk
If Fraxel setting are aggressive (as you suggested at 70mJ), the risk of hyperpigmentation is very real. I usually use lower fluences and lesser densities (area of coverage) to prevent this complication. For that reason, Fraxel Restore in my practice is done with less aggresssive, but more frequent treatments. I also usually pre-treat with retinoids and hydroquinone, make sure sunscreen is worn daily, and I try to do the procedures in the less sunny winter months.