Fraxel Laser a Good Option to Correct TCA Peel Damage?

I had a 25% TCA peel a year ago. The reaction to the peel caused a noticeably uneven skin surface on my forehead and left lines of demarcation where the skin cracked. My dermatologist recommends Fraxel laser as the only option to repair this. I am apprehensive because of the chemical peel side effects, which I was told there would be none. Would a Fraxel laser treatment correct these side effects, or is there a possibility for further damage? What is the realistic downtime for a repair treatment given that the TCA peel took about 20 days to recover from?

Doctor Answers 4

Fraxel treatment can correct irregular pigmentation

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However, you didn't mention what type skin you have.  If you have darker complexion, you may have similar side effects from the Fraxel laser.  It might be safer and be more conservative if you tried a series of retinoids and hydroquinones to correct the problem from the TCA peel.  Try to seek out another opinion in one who has alot of cosmetic experience.

Perhaps a lightening cream?

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If you developed irregular pigmentation from the peel, you might develop the same or worse from Fraxel or any resurfacing modality. Fraxel has helped many patients with such a scenario, but there is a risk and no guarantee. Have you tried prescription lightening creams yet?

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Fraxel Laser to Correct Damage From TCA Peel

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Hi Arguy,

Yes, both Fraxel re:store and Fraxel re:pair laser are excellent options to improve your skin after the adverse events with your TCA peel.

There are always risks and complications involved with any procedure. The benefits must greatly out weigh the risks before you have the treatment. This is best discussed with your treating physician.

Fraxel re:store will require a series of treatments, but your skin should only be slightly swollen and red for 2-3 days. Fraxel re:pair is more aggressive, there are less treatments, but at least a one week downtime.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Fraxel Laser (Re:Pair) Scarring

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The Fraxel Re:Pair may help to significantly improve your problem but it will depend on the severity of changes that you present with. The "downtime" is generally 2-3 days where you would need to apply compresses, but by the second or third day the skin will be fully re-epithelialized (raw areas repaired) and you will look like you have a sun burn for 2-3 weeks, but this can be covered with makeup. It is important that you seek out a physician well experienced in use of the Fraxel. The advantage to the Fraxel Re:Pair is that there are many variables or settings that the physician can use and he can customize the treatment to your particular problem. It may even be better to do this in more than one stage to decrease the risks of further problems. Your physician will also work closely with his medical esthetician to begin a pre- and post-procedure skin care program that will enhance the treatments and maintain them and decrease the risk of hyperpigmentation (darkening).

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

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.