Facial Scars from Laser Hair Removal and Fraxel

Question

I had several LightSheer treatments in the fall of 2003 to 2004 spring. This treatment worked fine but left hyperpigmentation and even caused some burns but they healed without scarring.  In the summer of 2007, I had 1 Fraxel Laser treatment. It did not go well. I had 1 Yag laser hair removal treatment about 4 months later that fall. I have brown skin (Indian) so I had low settings. The Yag laser hair removal was great, but I began to notice depressions in my skin. They were everywhere.  I've noticed my left side cheek is riddled with small follicle-sized holes. I can tell that my skin is of uneven depth on this side.   The difference between my left and right cheek is astonishing. Yet, I had both laser treatments on both sides. The technician sprayed cool mist on my face between passes. Is this the cause, and is it irreversible? Can dermaroller or needling help?

William Ting, MD · Answer

Depressed scars in ethnic skin particularly resulting from prior laser surgery warrants a more conservative approach. I would recommend regular microdermabrasion and topical retinoid under supervision of a board-certified dermatologist.

Andrew Campbell, MD · Answer

I have seen skin depressions from different lasers and for different reasons. Most likely, the YAG laser caused some injury to the subdermis of the skin and atrophy or loss of volume occurred. This created the depressions that you can see. They are usually relatively subtle, but obviously not so subtle to the person that has them.
I treat these like acne scarring. You can fill them, if possible, with fat, Juvederm, Restylane, Radiesse, or any other filler you desire. With your darker skin type, the only other option that comes to mind would be to use the Sciton Profractional laser. I have had great results using this laser for acne scarring, pox marks, and surgical scars of the face. You would want to be very careful with the treatment and use relatively low settings, but it should help at the very least.
Certainly dermaroller or needling could help as well, but I find that treatment to be less reliable.

Facial Scars from Laser Hair Removal and Fraxel

Answers (2)