I Did Laser Resurfacing on my Face 3 Years Ago and my Face is Now a Big White Scar? (photo)

What you are experiencing is not at all uncommon after traditional CO2 laser treatments. With aggressive treatments such as this, hypopigmentation is frequent and proper placement of the demarcation and some blending into the neck can minimize the contrast between treated and untreated regions. There is no way to replace the melanocytes that are responsible for skin pigmentation. However, I agree with Dr. Ort's suggestion to conservatively treat the sun damage in your neck to minimize the appearance of the demarcation between your face and neck. A conservative Fraxel laser treatment would also be helpful for your neck as well. I hope this is helpful.Stephen Weber MD, FACS

The old fashioned deep chemical peels with phenol, dermabrasion (not microdermabrasion) and carbon dioxide laser have been noted to lighten the skin's pigment.  The fractional carbon dioxide laser-induced hypopigmnetation has been noted to occur with a delayed onset, as much as one year after the laser treatment. The non-fractional CO2 laser has caused an earlier hypopigmentation. There has been some discussion whether Fraxel Restore laser can help repigment the lightened areas to some degree. Please discuss this with your doctor to learn of the advantages and risks.

I am so sorry you have had this occur to you, especially as CO2 laser-induced hypopigmentation and visible line of demarcation between treated and untreated skin has been well-reported in the dermatologic and plastic surgical laser peer-reviewed literature for many years now. This is nothing new, and yes, you did have over-aggressive laser resurfacing.

Unfortunately, while this was an error of judgement, it is neither malpractice nor negligence in my opinion. Yet, you have this permanent problem for which makeup is the only solution. More laser surgery may be able to soften the sharpness of the visible line of demarcation, but it will also lower the visible line of hypopigmentation on your neck, which is more likely to be patchy and blotchy than smooth and gently transitional. We want the latter, but usually end up with the former. And for you, yet another well-intentioned, but unfortunately unsuccessful, effort at improvement.

More laser surgery on the patcy and blotchy areas of the face might help to even-out the loss of pigmentation, but you will still likely require cover makeup on a permanent basis.

Research is being done on medications and procedures to aid in skin repigmentation, so it is wise to keep in touch with a Dermatologist at a major medical or research institution. But for now, there is no solution that can reverse overtreatment with a first-generation CO2 laser. Please click on the link below for more information aobut laser resurfacing if you are another pre-op laser resurfacing patient reading this post. Best wishes! Dr. Tholen