Can I Use Active FX or Fraxel:repair on the Dorsal Surface of my Foot to Remove Hyperpigmentation?

Question

I already got my feet diagnosed by a dermatologist and he said it is hyperpigmentation. He cannot explain why I have it though. He says lasers could make it worse, but I am willing to chance it anyway because they already look horrible.

	He said if i wanted to find out if the hyperpigmentation is linked to something harmful, he could biopsy it, but still he wouldn't have a proper solution for the hyperpigmentation. So can these lasers help me in this case? Has any doc seen a case like this?

Harold J. Kaplan, MD · Answer

Hello Adam.  We would not recommend either of the lasers you suggest.  Neither are ideal for pigmentation and both would create healing issues when used on an area like the surface of the foot.  These are ablative technologies that are better used for issues of texture than color.

We also would not recommend IPL as this lesion looks like it could be a birthmark.  Using IPL could make the mark darker.  For hyperpigmentation, birthmarks and other types of pigmented lesions, the gold standard is q-switched Nd:Yg lasers.  We use the Medlite C6 and the Palomar Q-Yag V.  In the link below you will see a good number of hyperpigmentation cases all treated successfully with these q-switched lasers.

We are also in Los Angeles and Orange County, if you would like to contact us for a free consultation.  Hope this helps.

Frank Agullo, MD · Answer

For hyperpigmentation in general I recommend using an IPL (Intese Pulsed Light) laser as well as topical hydroquinone 4% treatment. It seems that this hyperpigmentation is likely due to sun damage. Carbon Dioxide lasers such as Active FX and Fraxel would probably worsen the situation.

Mark Taylor, MD · Answer

What you have is possibly post inflammatory hyperpigmentation or hemosiderin staining caused by leaking capillaries or veins.  If you use an aggressive fractional carbon dioxide laser like the Fraxel Repair or Active FX  you may stimulate more pigmentation that potentially could look a lot worse than what you have now.

	 In my hands, the best treatment for this has been repeated treatments with low fluence Q-switched 1064nm tattoo removal lasers such as the VersaPusle or Revlite Lasers.  Using this in combination with M2 Skin Refinish 20% Mandelic Malic acid product once or twice a day will usually improve the appearance of this pigmentation gradually over a period of months or years.  Be patient.  Legs respond very slowly to any treatment.

Can I Use Active FX or Fraxel:repair on the Dorsal Surface of my Foot to Remove Hyperpigmentation?

Answers (3)