Will Erbium Laser Around Mouth and Undereyes Cause Uneven Pigmentation?

Question

I am wanting to do fully ablative laser (medium to deep)under the eyes and about the mouth only. I was thinking I might not have to be put to sleep if I have it done deep in just those areas. Have a microlaser full face at the same time. My question is with having just the under the eyes and above the mouth cause it to alway look a different color in those areas. That is why I am wanting to have the microlaser full face hoping it would help blend in any differents in color. What do you think?

Ron Shelton, MD · Answer

What you describe is done very commonly.  Fraxel Repair can be done on the perioral and periorbital areas while the rest of the face is blended with Fraxel Restore, Fraxel Dual, Chemical peel or other mild resurfacing. Compared to ablative non-fractional carbon dioxide laser resurfacing, there is much less chance of developing hypopigmentation in the segmented areas with the fractional CO2 laser treatment. Erbium, specifically, such as Fraxel Restore, and non fractional erbium can also be done around the eyes and mouth, but in this cirucmstance and Fraxel Repair, it does depend on your coloration and susceptibility to developing post inflammatory hyperpigmentation.

Mark J. Lucarelli, MD · Answer

There are several variables to consider, especially your skin color type (Fitzpatrick I-VI)  as well as the depth of the treatment around the eyes and mouth. The more sun damage one has and the darker one's skin is, the more likely that there could be a demarcation line between the deeper and more superficially treated areas. On a positive note,  unlike the occasionally seen complication of hypo-pigmentation with CO2 ablative resurfacing,  undesirable dramatic depigmentation with erbium resurfacing is not generally a concern.  Also, having a micro-peel over the rest of the face at the same session is a good strategy to help with blending.

Kris M. Reddy, MD, FACS · Answer

Whether you will have uneven pigmentation or the extent of uneven pigmentation will depend on the starting point of your skin, the settings utilized, and the skill and technique of the practitioner.

Mark Taylor, MD · Answer

Make sure you are seeing an expert to do this treatment.  The micropeel on the face and the deeper peel around the mouth and lower eyelids are two totally different levels of peel.  If the peel on the upper lip and lower eyelids is too deep you could have permanent hypopigmentation and scarring that cannot be fixed!

Melanie L. Petro, MD · Answer

The best way to prevent pigmentary problems is to pretreat the skin with retinoids & hydroquinone.  This is necessary in darker skinned individuals, but not usually fair skinned.

Will Erbium Laser Around Mouth and Undereyes Cause Uneven Pigmentation?

Answers (8)

Answer: Make sure you are seeing an expert to do this treatment.

Answer: Make sure you are seeing an expert to do this treatment.

Answer: Laser Resurfacing

Answer: Laser Resurfacing

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Will Erbium Laser Around Mouth and Undereyes Cause Uneven Pigmentation?

Answers (8)

Answer: Make sure you are seeing an expert to do this treatment.

Answer: Make sure you are seeing an expert to do this treatment.

Answer: Laser Resurfacing

Answer: Laser Resurfacing

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Recommended reading

Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.