Does FRAXEL Dual 1927 Treat Dermal Hyperpigmentation?

I do not want to get the 1550 wavelength, and since I don't have acne scars or wrinkles, I don't see the need. Will the 1927 alone treat dermal hyperpigmentation?

Doctor Answers 4

Fraxel Dual treatment for pigmentation

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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. 

West Hollywood Dermatologic Surgeon

Fraxel Dual - Use 1927

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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.

Brenda Dintiman, MD
Fairfax Dermatologic Surgeon

Hyperpigmentation is difficult to treat

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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.

Fraxel Laser

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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.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 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.