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

Question

I did the laser 2 years ago and the laser was way to aggressive for my skin I now have a very visible line between my face and neck. Im not able to have my hair up anymore because I feel so uncomfortable if people look at me from the side. Is there anything I can do to help my skin. When the summer is here as soon as I go outside you can clearly see the spots that was missed during the laser resurfacing and the line between face and neck.

Stephen Weber MD, FACS · Answer

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

Ron Shelton, MD · Answer

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.

Jason Pozner, MD · Answer

Hypopigmentation is a known complication of deep carbon dioxide full field resurfacing and its incidence is much less with erbium and with fractional devices. Treatment of hypopigmentation is difficult but an excimer laser may help as will blending into the non-white areas. In your area see Dr. David Goldberg in Hackensack.

Richard H. Tholen, MD, FACS · Answer

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

Jo Herzog, MD · Answer

Jan, I would have no reservation about lasering someone with allergies unless they had asthma. Even though we use a smoke evacuator I think that the plume from the laser might bother someone with asthma. I do not have asthma but can not do more than two lasers in a day as it seems to bother my airways. As far as skin allergies go, I would just make sure that your doctor is aware and uses very simple post procedure products.

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

Answers (7)

Answer: Hypopigmentation is very common after traditional (non-fractionated) CO2 laser treatments

Answer: Hypopigmentation is very common after traditional (non-fractionated) CO2 laser treatments

Answer: Hypopigmentation from CO2 laser

Answer: Hypopigmentation from CO2 laser

Answer: Hypopigmentation after laser resurfacing

Answer: Hypopigmentation after laser resurfacing

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Answer: This is not scarring, but it is permanent hypopigmentation and visible line of demarcation from CO2 laser.

Answer: This is not scarring, but it is permanent hypopigmentation and visible line of demarcation from CO2 laser.

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Answer: Allergies and Laser

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

Answers (7)

Answer: Hypopigmentation is very common after traditional (non-fractionated) CO2 laser treatments

Answer: Hypopigmentation is very common after traditional (non-fractionated) CO2 laser treatments

Answer: Hypopigmentation from CO2 laser

Answer: Hypopigmentation from CO2 laser

Answer: Hypopigmentation after laser resurfacing

Answer: Hypopigmentation after laser resurfacing

Recommended reading

Everything you need to know about Laser Resurfacing

Answer: This is not scarring, but it is permanent hypopigmentation and visible line of demarcation from CO2 laser.

Answer: This is not scarring, but it is permanent hypopigmentation and visible line of demarcation from CO2 laser.

Answer: Allergies and Laser

Answer: Allergies and Laser

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