Damage from Pearl Laser, How Do I Repair It?

I had pearl laser a year ago. Which they also fractionated. I am severly scared by the fraxel part on my cheeks. Very large area.You can actually see where it has melted the skin,with not only wholes from the laser, but whirl marks. I have had 19 dermabrasions done..and it seems the deeper we get on the skin, the worse the melting looks. It looks horrible. You can actually feel it under your hands when you put cream on it or wash it. So, not only just visible to the eye. Please help me!

Doctor Answers 3

Treating burns from laser - Los Angeles

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I see a lot of patients in my Los Angeles office who have had laser burns by others and begin treatment immediately depending on the problem. Raffy Karamanoukian Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Pearl Laser

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You should see a Board Certified Dermatologist or Board Certified Plastic Surgeon and they can assess the damage.  This laser is known for being very safe and I am surprised you have complications.  Find out how high the energy was set, the density, and how many passes were done.  This usually heals fine, but the user has the decision that matters most….how much energy and how dense the energy.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Scarring Following Laser Resurfacing

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I’d like to provide a better answer for you, but without more details regarding your treatment and accompanying pictures, I can’t. You mention three different laser procedures: Pearl, Pearl Fractional, and Fraxel.

The Pearl laser is unlikely to cause scarring when used alone. This is a very superficial laser procedure that only treats the upper portion of the epidermis, and affects the dermis only by heating it. Even in combination with the Pearl Fractional (a treatment referred to as Pearl Fusion), the Pearl portion of the treatment will not cause scarring.

The Pearl Fractional or Fraxel lasers could cause scarring but this is not common. The Fraxel is commonly used to treat acne or post-traumatic scarring, and the Pearl Fractional can be used in this manner as well. The wavelengths utilized in these lasers are different (1550nm for Fraxel, and 2790nm for Pearl Fractional) so the absorption by water in the skin is different. Both ablate tissue, but the Fraxel is coagulative (does not vaporize tissue), while the Pearl Fractional is ablative (vaporizes tissue). Both penetrate the dermis to affect changes and that is why these lasers are used to treat scarring and photoaging. The fractionated nature of these lasers means that only a portion (a fraction) of the skin surface is treated by the laser beam in a given session. Fractionated lasers allow effective treatment with quicker healing and less downtime. Typically these lasers are used to treat 10% - 35% of the skin surface; an amount that should allow simple healing in about one week in healthy skin. Once the percent coverage increases to 40% or more the likelihood of delayed healing will begin to increase. If the skin is compromised or has an altered blood supply, then the effect of a denser treatment may result in delayed healing and subsequent scarring. One way this may happen is if these are used aggressively over a face lift flap, where blood supply may be altered in the pre-auricular skin or along the mandibular border.

When you say “19 dermabrasions”, do you mean microdermabrasion? or dermabrasion? If you have some scarring in the skin, microdermabrasion is unlikely to offer much improvement. Usually microdermabrasion is very superficial; if done aggressively it could be aggravating the area, and repeated trauma could worsen the scar.

This is obviously a complicated issue that requires a thorough history and examination, and then serious consideration for realistic options.

I wish I could be more helpful. If you follow the link below you can read more about these lasers on my website by linking to the appropriate the pages in the left column.

Best wishes, Ken Dembny

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 36 reviews

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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.