“If You Can Only Afford 2 Treatments.....”

So far I've done 3 treatments and plan on doing a total of 6. Did you ever notice the scars getting worse or new ones appearing?

Thanks for the entry. It's nice to hear from someone who's both a provider and a patient. And I hadn't heard the fact that the improvement is exponential, which really does make going through the whole course of treatments sound necessary.

Dr. Molton, would the number of passes be limited by how aggressive you want to be, and how well the patient would tolerate the treatment? I wasn't counting the number of passes I received for my last treatment, but whatever she did, I ended up pretty red and swollen this time around. Not sure I'd want it to be worse than this.

I've had three fraxel restore treatments and the doctor wants to wait a few months to see if I like the results. Should I do 2 or three more treatments anyway? Is there a downside to waiting months in between treatments? I also am having the IPL for rosacea once a month. What should I do? I'm 49 large pores is the reason for the fraxel for me. Thanks,Tammy

Dr. Molton, is there any reason you couldn't repeat the Fraxel treatments every few years? Any limits to how many treatments you can have over a lifetime?

Dr Michael Molton, What would be your tmt for 49 year old white female fair skin large pores, but not necessarily breakouts, hundreds of milia underneath and above eyes. if my skin was tighter the pores would be gone. that's what happens when I pull my skin back. I do not need a face lift yet, not enough sagging skin yet. Is the YAG laser a serious skin tightner or is that a waste of hard earned money?

Dr Molton, do you think that using Tazorac before/after the treatments would help with the collagen rebuilding?

I certainly agree with Dr Molton's points. Our clinic has performed over 1200 Fraxel Restore treatments. We have had one small scar only in one patient, and none for the last 2 years. Results are really only begin to be seen after 3 treatments, and continue thereafter. We do see some temporary post-treatment hyperpigmentation in darker skin types, but no long-lasting PIH.

Should I be concerned if my doctor wants to treat only a part of my face with fractional laser? I have been on a course of hydroquinone 4% and retinoids for 6 months and have also had 4 IPL treatments. I have been pleased with the results -- except for a few stubborn age spots. The fractional would be to attempt to resolve the stubborn age spots and plump up minor acne scarring... I've asked if that will make just that part of my skin "look different" and he said "no" -- that this is the part of my face where I really need it done. I'm nervous and have not scheduled the treatment. My burning question I have is why NOT treat my entire face? I have had confidence in this doc and have been pleased with my treatment -- until now... Help. What other questions should I ask? I have to wonder if he's doing this on the "cheap" to save "tips" as you have described previously... Am I being overly cautious? I'm scared. I'm 46 and have decent skin -- with a few minor imperfections -- I just don't want to make it worse... Thanks!

Michael, my experience with melasma is that Fraxel erbium does help - we reserve it for people not responding to bleaching formulae. Settings are typically lowish: energies 15 - 30 mJ, level 11 - 12. Improvement is unpredictable, but typically 30 - 75%. Q-switched YAG 1064 laser is also beneficial. Some Drs report good results with IPL, but this is not our experience. In respect of area treated, I recommend treating cosmetic units/areas, eg, cheek, chin, upper lip, etc, as rarely, a slight textural difference can be noted in treated versus untreated areas.

I finished my 3rd session of Fraxel 3 weeks ago. My issues were pore size, broken capillaries, a few age spots, hormone hyperpigmentation, "puppet mouth" lines and some crow's feet. I am 54 years old. I tolerated sessions 1 & 2 pretty well. My skin texture improved and the brown spots & hyper pigmentation faded by half. Session 3 was cranked up to 65 (70 being the highest). It was very uncomfortable. My eyes swelled, and my neck still prickles when I get hot. But my puppet lines are not obvious, my crows feet are practically gone, pores are tight and I can't wait to do session 4 (yeah , right!) 3-5 sessions were recommended. I see a definite improvement. My friend who had 3 also is 60 years old but looks 10 year younger. I developed a swollen undereye this time, and am waiting until it goes down. Is it worth it? I believe so. I still need an upper & lower eye job to take years off my looks, but my skin looks so much more even and healthier. (I don't dare go out in the sun without #75 on! Too much pain & money was spent to ruin this work.The first time in my life I am actually taken care of my skin!) I find Cetaphil cream compliments the work as it makes my skin dewy & soft. PS I had a dermatologist perform my Fraxel & he is an angel.