Active FX on Olive Skin - Should I Request a Test Patch?

Hi...I'm scheduled to have an Active FX procedure next week. My concern is that I am Italian and do have a moderate amount of olive pigmentation. Should I be concerned about this? The Active FX is scheduled w/an MD, but he didn't say anything about my skin tone (except to stay out of the sun before & after the procedure). Should I request a test patch? Thanks!

Doctor Answers 4

Test patch is advised

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For darker skinned individuals such as you, we advise a test spot first. The reason is darker skinned patients have a slightly increased risk of adverse pigmentation problems after facial resurfacing. We deliver the test spot in an inconspicuous area (ie behind the ear) and if no unusual reaction occurs, you can proceed with the full treatment.

San Francisco Facial Plastic Surgeon
4.3 out of 5 stars 14 reviews

Absolutely request a test patch for Active FX

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If you have any questions about pigmentation changes from the laser, a test patch is a great idea. I would test just behind one ear. This way you can see how your body handles the Active FX. If you have not been given a pretreatment regimen, you should probably ask for one. This can help decrease the incident of side effects.

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

A test patch is a good idea.....

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We have had the DeepFX/ActiveFX system for two years now and I have yet to see any pigment changes as a result of treatments. If I see a patient with a darker skin type (III or IV) I test patch them behind the ear. My biggest worry is lightening of the skin (hypo-pigmentation). The loss of pigment secreting cells (melanocytes) can make the treated area look bleached.

It is believed this happens from damage occurring to the cells. Unfortunately, pre and post treatment plans are unlikely to prevent this problem as the heat from the laser is what damages the cells. I have seen hypo-pigmentation in dermabrasion patients and traditional CO2 laser patients but never with the Active FX. The reduced heat input is probably the reason. Even if you pass the test patch you could see hypo-pigmentation later on in 8-12 months. My advice, do moderate settings with laser. If you are fine a year later you can do a second treatment. Hope this helps.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Test patch helpful but no guarantee against pigmentation after laser resurfacing

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While it may be helpful to perform test patch prior to fractionated CO2 laser resurfacing, it is even more critical to work with a board-certified dermatologist or plastic surgeon to prepare your skin with a customized pre-op and post-op skin care routine at least 4 weeks prior to the treatment which may involve review of strict daily sun protection, topical bleaching cream, retinoid, etc. Even if you have a unremarkable test patch of Active Fx, Fraxel Repair, Mixto or other fractionated CO2 laser, there is no guarantee that there will not be any post-inflammatory pigmentation for ethnic/olive skin complected person. The key is to seek out a specialist who has performed greater than 50 cases of your skin type as there is a significant learning curve for treating olive and darker skin types with fractional CO2 laser resurfacing and you would not want to be a guinea pig.

William Ting, MD
Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.