Does Fraxel Work on African American or Black Skin?

Question

Is Fraxel appropriate for Black skin and hyperpigmentation scarring from acne? If so which Fraxel is recommended? If not what are the alternatives for Black skin?

Michael A. Persky, MD · Answer

Hi Turq,
Fraxel restore series is safe to use on Black skin for the treatment of acne scars.  There is the possibility of further hyperpigmentation and even some hypopigmentation (skin getting a little lighter).  In both cases the skin color changes are temporary and eventually return to a more uniform color.
Fraxel repair would not be indicated for Black skin.
Good luck and be well.
Dr. P

Ron Shelton, MD · Answer

Fraxel Re:store can work well to improve the depressions of acne scarring. Pigmentation of acne scarring usually means that the individual is susceptible to post inflammatory hyperpigmentation and this will result from the laser as well. The darkening can last for more than two years if it fades by itself. Lightening creams and chemical peels may help hasten the fading of the darkening color.

Ran Y. Rubinstein, MD · Answer

There are two types of Fraxel laser:

Fraxel restore- erbium based and less intensive laser
Fraxel repair- CO2 laser and more intensive.

I think that the Fraxel restore laser would be safer in treating Hyperpigmentation from acne and treat the acne scars. I use the Fraxel restore with great caution in someone with dark skin and use lower settings with more treatments to avoid making the Hyperpigmentation worse. I also combine it with a KTP laser at the same treatment session to improve the results. Pre-treating your skin with TriLuma will help prevent worsening the Hyperpigmentation and improve your results.
If you want to play it safe, try a combination of light chemical peels with TriLuma and resort to Fraxel if there is no improvement. This is the safest bet and lowest cost approach.
Good luck!

Edward E. Dickerson, IV, MD · Answer

The Restore would be the best course of action for African Americans.  If they are trying to treat PIH from acne, they will have a higher risk of pigmentation from the laser.  These can be treated with hydroquinone or other lightening agents.  With lower settings over a couple different sessions you can improve some mild acne depressions.  There is a great risk of hypo-pigmentation.  If both cases, the hyper- and hypo-pigmentation changes will go away over time.  Best advice would be to find a laser that is more suited for darker Fitzpatrick skin types.

	 

	"Dr.D"

Does Fraxel Work on African American or Black Skin?

Answers (4)

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