Can Existing Pigmentation Darken from Fraxel Restore Laser?

I am Caucasian (white) with dark brown hair & dark brown eyes. I had a test patch done to check if I would hyperpigment with Fraxel Restore. I did not. I know Fraxel restore can cause new brown spots (PIHP) in people with dark eyes and dark hair. It would appear that is no longer a risk for me.

I know to wear a high factor sunblock & avoid the sun. Is it possible for the existing pigmentation (a few flecks) 2 darken if I get Fraxel Resore? Or does this always lighten when the laser goes over it?

Doctor Answers 5

Changes in skin color after laser

Dear Kelly, The short answer to your question is that there is always a risk the skin color can change after any laser treatment, either lighter or darker.  This is somewhat unpredictable, but certainly the darker the skin, the more the risk.  Also, I believe, the stronger the laser, the more the risk.  I would typically characterize the Fraxel Restore as a low risk laser for undesirable skin pigmentation issues, especially for someone with fair skin.  It can be set to treat superficially, which is better to get rid of dark spots on your skin, vs a deeper setting for wrinkle reduction or acne scars.

Good Luck,

Yoash R. Enzer, MD

Providence Oculoplastic Surgeon
3.4 out of 5 stars 8 reviews

Pigmentation risk very low with Fraxel

I have treated hundreds of patients with the fraxel restore (erbium) laser. I have never had a problem with pigmentation in Caucasion skin. Even in darker skin individuals - asian, Indian skin types - skin darkening is extremely rare and most often seen when we are trying to treat pigment or melasma or when we are using high settings to treat acne scars. I have treated a large number of dark skin patients with Fraxel with only a few patients having some darkening and that is always treatable and reversible.

Elizabeth F. Rostan, MD
Charlotte Dermatologist
4.2 out of 5 stars 19 reviews

Hyperpigmentation usually helped by fraxel restore

in hundreds of cases over more than three years, i can only think of one patient who had more hyperpigmentation after treat ment than before. fraxel is in general an extremely good modality for treating hyperpigmentation issues, but clearly it can sometimes be a very stubborn vexing problem with a strong tendency to recur.

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.6 out of 5 stars 13 reviews

Post inflammatory hyperpigmentation after Fraxel

You had a test spot that did not hyperpigment. That's good but does not guarantee you won't when you have a full treatment.  If you failed your test then your doctor would probably suggest not to go through with the facial treatment, but as you passed the test, you must realize that you still may hyperpigment.  This darkening is rarely seen right away. In fact, the new Fraxel treatment could lighten existing spots, but your pigment may develop a darker color a few weeks later.  Lightening creams, chemical peels, and good sunscreens and sun avoidance may all be suggested to treat a post inflammatory hyperpigmenation should it occur.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Existing Pigmentation and Fraxel

As you mentioned you had no problems with a test spot. There are no guarentees with laser but I do a lot of it ,and from your description of skin type and your good test, I would not hesitate to do fraxel restore on you

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

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.