Fraxel Laser for Acne Scars on Asian Skin?

PIH (Post inflammatory hyperpigmentation) is possible after Fraxel and numerous other laser treatments for your skin type. With that said, we offer Erbium resurfacing for acne scars and rarely have the condition develop. It occurs in less than 5% of Asian and Hispanic patients in our practice. We would suggest looking into the following laser options. While PIH can and does occur in some patients, it is most often transient. We would focus on finding the most appropriate laser technology for the type of scars you have and then weight the risks and benefits from there.

Erbium Laser Resurfacing
Fractional Laser Resurfacing (including fractional CO2).
Full CO2 resurfacing (depends on how severe your case is).

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Fraxel has worked very well to reduce acne scarring in some individuals.
Fraxel has worked very well to reduce melasma, or facial pigmentation, in some Asians
There is no guarantee that you won't devlop a hyperpigmentation. A test spot can be performed behind your ear first and if no reaction develops, another test can be done, this time on the frontal face. If you develop post inflammatory hyperpigmentation from the test, then you shouldn't have the treatment, especially if this pigmentation doesn't clear wtih appropriate counter measures. If you pass the test, and no pigmentation occurs, it unfortunately doesn't mean that you won't develop the hyperpigmentation.
Proceed cautiously.

Hi Jilodo,
Asian skin is prone to post inflammatory hyperpigmentation (PIH) which causes the treated skin to darker more than untreated areas. Patients need to weigh the benefits of improving their scars verus the risk of living with darker skin for an unpredictable amount of time. We have treated many Asian patients, the PIH always fades over time.
Most Asian patients are pretreated with topical skin care to help minimize possible PIH, and then treated after their laser treatment with skin lightening products. Fraxel restore is much less likely to cause PIH than Fraxel repair.
Your skin should not be burned.
Good luck and be well.
Dr. P

You can undergo Fraxel laser treatment as long as your acne breakouts are under control. We all have or or two pimples now and then, and it is completely fine to proceed with Fraxel treatment. It is important that your provider thinks that your skin is ready for laser treatment in order to minimize any side effects. Moreover, your provider has to know what topical and oral medications were you using since there has to be certain time gap between your last application or dose and first laser treatment (as it is the case with Accutane and other medications). Good luck!