Fractional Laser: Stories

I had fraxel done on a Monday 2 weeks ago, mainly for hyperpigmentation due to years of sun exposure while on birth control and also for mild acne scarring. An RN did the procedure and honestly, it was pretty painful. Just like others described, It felt like a very HOT rubber band was being snapped repeatedly over (and into) my face. It was especially painful in the upper lip area.

During the consultation the nurse asked if I wanted to treat aggressively to seek better results, but warned that it would mean more "down time". I do not know the settings she used so cannot post them here. Immediately after my face looked really red and pissed off. Not a lot of swelling, but very burned looking. I had circular red marks all over my face and tiny raised grid lines, like a pool screen had been wrapped tightly over my face! The heat my face felt for the first few hours was pretty bad but subsided over the next few hours.

Over the next couple of days my skin looked worse. Not swollen but the circles bronzed and turned very dark and rough. My face felt like a paper towel to the touch. The little raised grids areas turned quite dark. By Thursday I had to leave the house and tried using the mineral makeup to help hide my leopard spots but it really looked almost worse with makeup.

My face started peeling on Friday and I was able to leave the house with makeup. I was very flaky and you could still see the leopard spots through the makeup, but from a distance I didn't look so bad. The next 2 days I had a lot more peeling and the new skin was very pink with a few red and almost raw looking patches.

By Sunday morning, most of the skin literally rolled off when I showered. My new skin texture looked smoother but was VERY pink, almost red. You could still see the circle patterns but my skin wasn't as rough.

I have been wearing makeup since then because of the circle spots. My face continues to peel and although the circle spots have faded, they are still visible. It almost looks like I have verticle stripes, especially on my forehead. I have had several tiny pimples appear over the course of the last two weeks, but no cystic acne. Just surface pimples. I have worn sunscreen everyday and there is also sunscreen in the makeup I wear. I'm wondering if this is PIH and permanent, or if I can expect the red areas to continue fading. Also, is it normal for my face to continue peeling? My skin was a bit dry before the fraxel, but is definitely drier now. I have a post-op appt on Wed, but I'm starting to freak out a bit since I am still peeling and the pattern on my face hasn't disappeared. Is this normal? I look pretty good in makeup on the days I'm not too flaky because the fraxel has already improved the acne scarring but the uneveness in my skin tone is starting to worry me. Let me add that I have not picked or peeled at my skin, but have kind of allowed it to roll off under my fingertips while in the shower, starting on day 6 after the procedure.

I has been 5 weeks now. My skin tone is still not completely uniform, but is slowly, slowly evening out. I may have a little hyperpigmentation on my temples, but I had another plastic surgeon (a friend I saw at a conference) look at my face and he said he didn't see anything that concerned him. Said it can take a while to heal when the treatment is aggressive and to just be patient. I've continued to find milia, especially on my chin and cheeks. Had a follow up visit with my RN and she suggested a chemical peel to speed along the process of evening out my skin tone and helping with the milia. I had the peel done 4 days ago. My face started shedding last night and so far, so good. The new skin that is starting to appear looks even and smooth. I will update again after I am done shedding.

It has been 9 weeks since I had my fraxel treatment so I thought I'd provide an update. Overall, with regards to scarring and melasma, I would say my skin looks slightly better in some places, worse in others. Either way, I still have to wear makeup daily and I'm out the money. I actually didn't have fraxel, which is a brand of laser, but had fractional laser treatment with a Palomar laser (sorry, not sure which model or setting). At this point I would have to say that it was not worth it. A month after the procedure I still had some redness and what appeared to be mild hyperpigmentation. My RN suggested a medium chemical peel which was a combination of Salicylic 30%, Glycolic 40% to 70%, modified Jessner 14%, Alpha Beta 17%, and Retin A. This helped tremendously with the hyperpigmentation and helped some with all the milia that formed as a result of the laser. However, there are other results of the laser I should share. First, this made my acne come back with a vengeance. I struggled with mild to moderate acne throughout my teens into my early thirties but finally had it controlled for the last 10 or more years. I would recommend if you are acne-prone you might want to consider other options, like perhaps a chemical peel which actually helped clear the acne and milia the laser created. Second, the laser treatment resulted in the reappearance of old scars. I opted for laser to treat melasma and mild acne scarring. The scarring which I had is mostly still there, in addition to some old scars which had faded and were no longer really noticeable. Third, I have some new scars from the treatment, two or three tiny ice-pick scars, a scar type which I have NEVER had before. Fourth, the texture of my skin is different now, might be what others have referred to as orange peel, though mine is not consistent everywhere but is rough in patches. Finally, I can still see the tiny grid pattern in some areas on my face, especially around my chin and mouth, and in some places on my cheeks and temples. I am beginning to wonder if this will ever go away as I am now into my third skin cycle since the procedure.

I don't want to sock it to my RN, so I will try to be fair. She seemed very knowledgeable and her bedside manner was great. However, she did not go over the consent form and explain or elaborate on the potential side effects. She simply gave me the form, let me read it while I was numbing, and asked if I had any questions about it. Right before the procedure she asked if I wanted to treat a little more aggressively, which she said would result in more "down time" but with greater results. She never said the potential risks would be increased as well.

I am not on a mission to scare anyone, as some others on this site have done. I think this may be a good procedure for some, depending on their skin type and the skill of the person treating them. I would recommend, as others have, to research your facility thoroughly, and make sure you are being treated by a certified plastic surgeon, NOT their tech, and make sure they have done LOTS of these procedures. You don't want to be the 5th person they've ever treated. Also, I wouldn't recommend going to a regular MD who has obtained the certification but is NOT a plastic surgeon. I've noticed that those in the industry seem to really push the low amount of down time from laser treatment, as if you can go right back to work with what looks like a sunburn. This might be possible with a very low setting, but was not what I experienced. I looked like a swamp beast for several days so the immediate reaction to the laser can vary widely from one individual to the next. Plan on at least a week before you're ready for public display if you want to be on the safe side. I would also recommend insisting on a patch test, and if that works out ok I would then recommend a low setting treatment and only moving forward with more aggressive treatments if you are getting positive results.

I will post again if I notice any other changes over the long term, whether good or bad.

After 3 1/2 months I am continuing to feel it was definitely not worth it. My skin looks worse with each passing month, partially from the acne that the procedure caused. My skin is still trying to purge all the milia that formed as a result of the treatment. I am noticing broken capillaries that were not there before and my color is anything but even. I am having my procedure report faxed to a plastic surgeon friend for review. Hopefully, he can make some recommendations to help fix my face. Fortunately, my results are not tragic, like some have experienced, but undesirable nonetheless.

It has now been 5 months. Fraxel definitely not worth it. My skin is improving, though. Based on a recommendation from another plastic surgeon, I am doing regularly spaced light chemical peels. I have chosen to do at-home tca peels every month. Since having the office peel in late Dec, I have now done 2 tca peels, 3 layers of 15%, at home with decent results. Using this light peel the progress is slower, but steady. I recently added dermarolling to my routine as well. Too soon to comment on that.