Hyperpigmented Breast Scars After Fraxel Laser

A year ago I had Fraxel treatment on some keloid scarring on my breasts from a reduction I had about 10 years ago. The doctor treated my keloid scars first with IPL followed by Fraxel during the same visit. My scars are now dark brown and I am horribly disfigured. The doctor said this happens to about 10% of patients who have Fraxel and there is nothing she can do. I've tried bleaching creams and further IPL treatments but nothing has helped. Is there anything I can do?

Doctor Answers 1

Treat hyperpigmentation

There are a number of ways to treat hyerpigmentation in a scar. Hyperpigmentation is difficult to treat and must be done slowly, carefully and gradually so that what happens is a gradual lightening closer to normal skin color rather than complete removal of all pigment or color so that the area is lighter than normal skin color or even white.

Q-switched lasers (such as are used for tattoos) as well as longer pulse duration alexandrite 755nm lasers can be used to target pigment. There is usually mild crusting after treating a dark area of skin with one of these types of lasers. We commonly use the GentleLase long pulse alexandrite laser (hair removal laser) in my clinic to lighten dark scars both on and off the face. Lighter pigment may be better treated with a tattoo laser.

Ironically, the laser that led to the problem - fraxel - can be very good at treating the darkness in your scar. A series of lower energy treatments that are less aggressive are likely to help your scar.

LIght chemical peels can help lighten pigment as well. We often use a few coats of a Jessner's peel with or without very low concentration TCA.

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