Does Fraxel cause the skin to tan?

Question

I had co2 laser 2 years ago and had hyperpigmenation afterwards. I received fraxel 3 days ago to correct some of the melasma. Is it normal to look tan? How long does that last? By the way, I am Asian.

Rebecca Fitzgerald, MD · Answer

The "tan" could be the initial bronzing that affects all patients. What you want to be very careful of at this point is sun exposure.Asian skin in general tends to experience post treatment hyper pigmentation - with lasers specifically - and heat-based treatments in general. Many physicians will pre-treat skin with a pigment suppressing agent to help prevent this...as well as using pigment suppressors afterward in conjunction with sun screen.Alternatives to Fraxel and other lasers do exist - eMatrix, micro needling, chemical peels and the use of creams that contain ingredients to lessen pigment formation. Hydroquinone long term is not generally recommended as there can be unexpected discolorations from over-use; but it is used to pre-treat or post treat for short periods of time.

Harold J. Kaplan, MD · Answer

Hi Amy. The "tan" after Fraxel is the same as the hyperpigmentation after CO2 resurfacing.  Because you are Asian and a medium skin type, the reaction of the skin to trauma is darkening or the development of excess melanin during the healing phase.  This should go away, but may need to be aided by the use of a hydroquinone lightening medication.On a different note, although Fraxel is FDA approved to treat Melasma, it cannot cure the condition.  Typically any benefits that come from a fractional resurfacing procedure for Melasma will disappear within 1-2 months. so even if you do get temporary results, you will revert back to where you have been previously with the Melasma and in some cases it can get worse.The link below contains before and after photos of Los Angeles Orange County Melasma patients that use our high strength liquid form of hydroquinone to maintain lasting results for their condition.

Michele S. Green, MD · Answer

Fraxel is a great laser for fine lines and hyper pigmentation.  However, I advise against Fraxel with Asian skin since it can lead to melasma and hyperpigmentation.  For this reason, I often use the eMatrix in Asian skin.  Melasma is not treated with Fraxel and last year the Fraxel company came out with a statement against trying to treat Melasma with Fraxel.  Cosmelan is a much better treatment for Melasma.  Best, Dr. Green

Martie Gidon, MD, FRCPC, FAAD · Answer

Bronzing of the skin can occur about four days after Fraxel laser treatment and it then flakes off.  It is very important to avoid sun exposure after the Fraxel laser, especially if you have melasma.  You will probably need to use lightening products.  Follow your dermatologist's recommendations for maintenance treatment.

Robert Bacigalupi, MD · Answer

Post procedure the skin is inflamed and irritated due to the resurfacing. In darker skin types including Asian skin, inflammation can appear dark or hyperpigmented. When treating dark spots such as freckles and even melasma, an immediate darkening can be noticed before healing is complete. Also, there can even be post-inflammatory hyperpigmentation where tanning can be noticed after wound healing but will go away with time. Sun protection and bleaching agents such as hydroquinone can help shorten the course. Hope this helped.

Does Fraxel cause the skin to tan?

Answers (5)

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