Looked Good for About a Week and then MUCH, MUCH Worse - Concord, MA

I had the Sandstone Fractional c02 laser on May...

I had the Sandstone Fractional c02 laser on May 25, 2011 to address melasma. I went to a board certified plastic surgeon in Mass. The procedure itself was pretty painful, but I figured "no pain, no gain".

For about 5 days after I had the usual bleeding, crusting, and peeling that I had been advised to expect. After all the dead stuff had come off, my skin looked very "full", kind of red and inflamed. I had hope that the brown pigment wouldn't return.

About a month later, I noticed that there was a brown pattern all over my forehead, NOT by the way where my original melasma was (which was on my cheeks). You could literally see the pattern that the laser took! I also developed excess pigment on my upper lip, and under both eyes.

I also noticed that my skin TEXTURE had changed, as many others have noticed, to looking like the peel on an orange.

Additionally, I have developed one large cyst like formation on my jaw. I believe that this is SCAR TISSUE. There are also several small areas on my chin that seem to develop excess skin. These are not red, nor are they pimples... more like too much skin is building there and isn't shedding like normal skin. It's kind of like psoriasis.

I went back to see my PS who was perplexed and referred me to a dermatologist.

The derm suggested that the brown discoloration is Post Inflammatory Hyperpigmentation - a condition that is very difficult to treat. He has me on a combination of Hydroquinon (4%) and Retin-A every other night, which causes extreme dryness and flaking. He doesn't know what to do about the scar tissue or the chin 'psoriasis'.

Please be assured that I have been hyper-vigilant with my sun protection since having the procedure. I wear a super strong zinc sun screen, I spend minimal time in the sun - just walking to my car and back, and I always wear a huge hat when I am outside for any longer than that.

I followed the post-op care to the letter and still had HORRIBLE RESULTS. I sometimes look in the mirror and don't even know who is looking back at me.

Please, please reconsider having this procedure. There are so many people out there who have had similar results to mine. This is your FACE you are gambling with!

So just to recap: worse hyperpigmentation, disgusting orange-peel texture, formation of scar tissue on jaw line, and strange excess skin growing on chin. Was it worth it? Nope. Do I wish I could go back in time? You bet.

Name not provided

The doctor was actually very pleasant and returned my phone calls as soon as I started experiencing problems. The office was very nice, as were all of the people that worked there. But I can't give him a higher rating because my skin now has worse hyperpigmentation, a disgusting orange-peel texture, the formation of scar tissue on jaw line, and strange excess skin growing on chin.

3 out of 5 stars Overall rating
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Comments (9)

First I want to say I am so sorry about what happened to your skin. I too have melasma and know how bad that can make one feel, let alone getting a procedure that makes the melasma worse and adds new issues to the list. I so appreciate you sharing your story--you are helping so many of us who were considering a similar treatment. Wishing you the best.
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I am so sorry for what happened to you...the same thing happened to me too...after one and only fraxel restore dual...tiny holes that connect and make lines on treated areas...when I pointed them out to my Dr he said he couln't see them but at the end contradicted himself and said that my skin will eventually heal and improve! He never mentioned this as a possible side-effect only hyper pigmentation in case of sun exposure and minimal results. I am now 8 weeks post fraxel one and only procedure and praying that my skin will eventulaly go back to normal... How is your skin now? What products did you use? How long did it take for your skin to look better?
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@FSRB, I'd say both the texture and the pigment are about 60% improved from the original photo. I've been doing the Obagi NuDerm system for about 7 months.

I would NEVER put another laser to my face though. I learned the hard way.

I will never be beautiful again, but luckily I have other things like heart and soul to lean on.
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How is the texture?  Hyperpigmentation?  I hope you have found a resolution!! 


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Several things come to mind here--first, a Co2 laser generates a lot of heat, which is the absolute worst possible thing for Melasma. At our facility, we usually treat Melasma with a 30-day course of bleaching cream before anything else. We may still use a C02, but it will be at very low settings--never enough to cause the peeling or redness. We will do 3-4 sessions at this lower setting or else use an Erbium lasers, which uses no heat. Sorry for the bad result. Just because a doctor is board certified does not mean he is competent or that he understands light-tissue interaction. He may be a wiz with liposuction, face lifts or breast augmentation but be totally clueless about lasers. Board certification doesn't address this. Stay on the bleaching cream, avoid sunlight and get some Erbium ablation for the orange peel. It will get better once your skin re-epithelializes.
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You are still early in the healing phase. Go to a burn center for evaluation. You may be able to use pressure garments or receive therapy to breakup the scar tissue that has formed creating the texture. In hindsight this is what I would have done.
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Hi spotted, 

I'm so happy you decided to post a review. Bowman9 and the other community members are sure to provide you with support and info. Please keep us updated as things progress or what you will do next. 

Thanks so much,


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I just saw you were in Concord. Have you seen anyone at Mass General for their opinion?
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spottedface.... I am sorry for your experience!! We have a very similar outcome. I have the orange peel texture and hyperpigmentation. With patience, the latter has gotten better. I truly wish I knew what to tell you to help you. I am 14 months out and I have not found the answers yet. Hopefully, someone will come along and help! Best wishes for a complete recovery!!
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