Chemical peel for fractional CO2 texture damage? (Photos)

Question

I previously had a fractional Co2 laser procedure that was supposed to correct some light acne scarring and rejuvenate my skin. The procedure left my entire face covered in orange peel texture. Would a medium depth peel correct this? Would it require a series of treatments? Unsure how to correct this.

Nelson Lee Novick, MD · Answer

I am really sorry that you have had this problem. I have been cautioning my regular followers for years already that the ablative CO2 laser treatments, much like aggressive dermabrasion runs the real risk for the subsequent development of scarring and dyspigmentation, as well as the kind of glossy, orange peel appearance you describe and is evident in the photos. Sorry. Unfortunately, it can be a difficult problem to treat. However, a series of professionally performed manual microneedling sessions (no need for the additional expense and risks of RF microneedling) may be helpful for improving both the superficial texture and color of the skin. Hope this helps and of course going forward exercise a great deal of "buyer beware" caution when being hawked other expensive gizmo treatments. Hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

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