Discoid lupus erythematosus (DLE) is a chronic, scarring photodermatosis which occasionally occurs in patients with systemic lupus but usually occurs on its own. About 5% of patients with DLE go on to develop the far more serious and less common systemic lupus. Sun avoidance is of paramount importance. The one patient of mine who died from SLE began with discoid lupus, liked gardening, did not heed my advice and her rather tame DLE turned into the ravenous wolf which is systemic lupus. Anti-malarials such as Plaquanil are usually successful in treating the lesions of discoid lupus. Hopefully, you do not smoke. There have been a number of papers showing that smoking decreases the effectiveness of DLE. So if you smoke...quit... it might make the Plaquanil work better. It practically goes without saying that you should be assiduous in wearing sun screens and adequate clothing. Besides topical steroids the calcineurin inhibitors such as Protopic or Elidel are also commonly used. If Plaquanil does not work, Thalomid, may be added. Yes, that thalidomide, the horror of the 1950's and one of the great pat-on-the-back stories for the FDA. ( The FDA held up the approval of this drug as reports of its teratogenicity among European babies began to filter in. I remember going to the Brockton Fair as a teen and seeing some thalidomide babies in a side-show. We have better sensitivities today and I doubt whether that sort of exploitation would be tolerated today.) I have found intralesional injections of steroids ( triamcinolone acetonide 3 mg/ml) to be the most effective treatment for this condition. Systemic treatment with Dapsone and in some cases Mycophenolate Mofetil ( Cell-Cept) or Azathioprine by be used. All three of these are big time drugs with the attendant side effects. As far as laser treatment, I do not know of any studies using a Fraxel. There was a recent paper in the April 2009 issue of the Journal of the American Journal of Dermatology by Erceg et al that demonstrated success with the pulsed dye laser in treating the lesions of DLE. Off hand, if you want to go the laser route, I would chose this laser over the Fraxel. At least until the latter has been studied. I would return to the dermtologist who has been treating you. He/she has a number of options remaining in treating your problem.