3 IPL and Fraxel treatments and my skin still looks bad. Is this normal? (Photos)

Question

I'm doing 4 treatments of fraxel and IPL. The first 2 treatments looked like this would be successful but spots came back even darker. 3rd treatment the same thing, spots darkened flaked off, had clear skin for a week then spots came back darker. I'm going in next week for my fourth treatment. I really don't think this is working but I don't know what to do? Spoke with the doctor who said I have low vitamin D. She perscribed me 50,000 vitamin D, 4weeks later no change to skin. Please help.

Jason Emer, MD · Answer

A combination approach will give the most improvement. This can be improved with a combination of Cosmelan, lasers, Aerolase, microneedling/prp, skin lightening, peels, and skin care. Sun protection is essential. I recommend getting a formal evaluation a cosmetic dermatologist. Best, Dr. Emer

Davin Lim, MBBS, FACD - Account Suspended · Answer

Hard to say if this is pure PIH or an element of melasma. Stop all laser treatments and follow the melasma protocol to help with discolouration. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’)

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher.

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.

3 IPL and Fraxel treatments and my skin still looks bad. Is this normal? (Photos)

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3 IPL and Fraxel treatments and my skin still looks bad. Is this normal? (Photos)

Answers (2)

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Everything you need to know about Fraxel Laser

Our mission is to create a world where every investment in modern beauty is Worth It.