Is Fraxel Effective for Treating Hyperpigmentation That Results from a Vitalize Peel?

I am of a Latina with olive skin and got 3 vitalize peels to treat acne scarring, but I ended up with hyperpigmentation that worsened with each treatment. I had a Fraxel restore treatment 2yrs ago for my acne scarring with great results but will it work as well for this type of hyperpigmentation? I want to get a fraxel treatment to "jump start" the process rather than waiting 6 months for something like obagi nu-derm to work because it looks so awful. What would you recommend?

Doctor Answers 4

Fraxel for Acne Scarring

If you want the greatest improvement in the shortest amount of time, I'd recommend having the Fraxel Re:pair laser treatment for your acne scarring/skin discoloration. The Fraxel Restore is a fractionated non-ablative laser that requires multiple treatments; the ultimate result after several treatments - in my opinion - is not as impressive as what you would have after one treatment with the Fraxel Repair (fractionated ablative, carbon dioxide laser). The fractionated ablative laser has a week or so of downtime. Depending upon the severity of facial acne scarring, some patients may need two to three treatments. However, again, you would experience quite a bit of improvement after just one treatment.

Post-inflammatory hyperpigmentation (PIH) is a concern whenever we use a laser, especially on patients with darker skin types. HOWEVER, PIH is a transient condition (it will resolve spontaneously over time), which can resolve quicker if treated with one or more topical lightening products.

Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Treatment for pigmentation following a peel - is fraxel a fix?

All patients with dark skin must be very careful with any invasive (laser, peel, abrasion etc) treatment of the skin because of something known as "post inflammatory hyperpigmentation" (PIH).  PIH occurs when anything inflames the skin, including acne and other injuries.  There is an increase in melanin production, which if then exposed to the sun becomes even worse.  I have seen this as a result of Fraxel and almost every other laser.  Once PIH occurs, the treatment is daily complete sunblock, and a variety of depigmenting or bleaching creams, including, but not limited to retinoids, nicacin, Elure, Lumixyl, kojic acid and hydroquinone.  Usually 2 or 3 are used in combination.  After several months, very cautious treatment with Intense Pulsed Light at very low energy settings will further improve the process.

Stephen Mandy, MD
Miami Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Fraxel lasers may help with pigmentation

This is very difficult to predict.  Fraxel lasers have a strong safety record in olive skin and for pigmentation disorders.  It works by damaging columns of skin which are then extruded or 'spit out' by the skin as the fine crusts you feel after the treatment.  If it causes hyperpigmentation, it will resolve, but in the process the lighten the hyperpigmentation.  I must say that it is unpredictable and if I treated you I would make sure to do a gentle treatment or two before raising the settings so that you have a safe experience.  In the meantime, you may want to try some bleaching creams to see if it helps and if you do decide on Fraxel lasers, you may want to pretreat with bleaching creams to lessen the postinflammatory pigmentation from the laser.

Good luck.

Daniel I. Wasserman, MD
Naples Dermatologic Surgeon
4.0 out of 5 stars 2 reviews

Fraxel is generally not a great treatment for hyperpigmentation.

Fraxel is generally not a great treatment for hyperpigmentation.  Often hydroquinone bleachers as well as intense pulse light can be better.  Sometimes, depending on the type of fraxel (i.e. an ablative fraxel), it can make the hyperpigmentation worse.  You must be careful. 

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 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.