Does FRAXEL Dual 1927 Treat Dermal Hyperpigmentation?

Treating hyperpigmentation with ablative, or semi-ablative lasers/Fractional lasers is controversial.  You may improve as some do, or the condition may get worse.  There is risk present to get worse.  If you are not willing to take the risk, then try chemicals first such as HQ, Kojic Acid, Retin-A.

The Fraxel dual using the 1927 wavelength works nicely for pigmentation as a result of sun damage and can help with melasma. There are different kinds of melasma and not all will respond to treatment. Its very important to use a sunscreen with titanium dioxide and zinc oxide to prevent the pigment from recurring. Personally, I loved the way my skin felt one week after having a fraxel 1927 treatment. My skin was very brown and appeared tanned and swollen for 4 days then actively flaked off and was clear. Many people will need a second one.Make sure that your doctor thinks that you are a good candidate to begin with.

Hyperpigmentation depending on the cause may best be treated with a combination of hydroquinone, chemical peels, and retinols or topical retinoids.  If is best if you go to an experienced cosmetic dermatologist for a consultation.  A lot depends on your skin type and the cause of the hyperpigmentation.

The Fraxel Dual laser has 2 wavelengths: 1550nm for deeper pigmentation, wrinkles, and acne scars, and 1927nm for more superficial pigmentation, sunspots, rough texture, and milder sun damage.  True dermal pigmentation is usually caused by melasma or occurs after trauma to the skin, especially in people who have darker skin or tan easily (post-inflammatory hyperpigmentation or PIH).  This type of pigmentation can be very difficult to treat and, in some cases, can be exacerbated by laser therapies including Fraxel.  My approach to a patient who has melasma and/or PIH is to pre-treat them with a bleaching cream such as hydroquinone for at least 2 weeks prior to treatment with the Fraxel.  I often will use both wavelengths in a treatment session to target the superficial and deeper pigmentation.  If you truly have dermal pigmentation, the 1927nm wavelength alone may not penetrate deep enough to target it and may cause it to worsen.  Once the patient is healed, the bleaching cream should be continued to prevent PIH.  In certain patients, a short course of topical anti-inflammatory creams can also be used to prevent PIH.  There are risks involved with any laser treatment, so make sure that your physician is skilled in using both Fraxel wavelengths on all skin types.