Confused About Laser Resurfacing Treatments After Disappointment with CO2

Question

I am Mexican and Filipino, but the Mexican side is questionable, as I may have French roots because I'm very fair and have had freckles as a child through adulthood. When I had hyperpigmentation/melasma  and fine lines under my eyes I went to get a CO2 treatment. The results were less than satisfying; I ended up having more lines on my lower lids plus hypopigmentation on the area, as well as above my upper lip. I have consulted various doctors, and I am overwhelmed with their suggested treatments: Fraxel Restore, fraxel Re:Pair, Plasma, and Cool touch, can't remember the rest. Is there anything that can help me get rid of the fine lines without causing more undesirable effects like the ones from my CO2 experience, which made me wary of laser treatments. I was told that I would have smooth skin--but I didn't. It would be two years in December since my treatment (2006) and I am still red/brown on the lower side of my lips. Thank you for any help.

Sonia Badreshia-Bansal, MD · Answer

With your ethnic background, treatment around your mouth is a higher risk procedure.  Thus, I would not treat you with CO2 laser there.  You will need a full evaluation with a Board Certified Dermatologist and Plastic surgeon to evaluate what risk profile you present, and your list of options.  Your skin type is high risk so you must go to someone familiar with ethnic skin, and your type of problem who uses lasers that are safe with ethnic skin.*

Vincent N. Zubowicz, MD · Answer

The CO2 laser is the most aggressive of resurfacing laser techniques.  It can produce great results but also significant unwanted collateral.  The results are directly related to patient selection.  CO2 lasering is limited, for the most part, to fair skinned individuals.  Loss of skin pigment is a common side effect and darker skinned individuals can look most unusual after this treatment.  It sounds like you little effect and lots of collateral.  You, perhaps, should leave things alone.

Amir M. Karam, MD · Answer

First of all, with your ethnic background, lasers can have greater potential side effects. Hypopigmentation is just one problem which happens to be permanent (in most cases).
The first step is find a facial plastic surgeon, plastic surgeon or dermatologist who truly specializes in lasers and has a variety of lasers at their disposal.  Most people have one or two different types of lasers and try to treat everyone in the same way.  It takes a wide range of laser devices to treat the even wider range of skin types of skin related problems. 
Further, not everything can be effectively treated with a laser.  The wrinkles under your eyes, may be better treated with a surgical approach or even with volume augmentation.  
Bottom line, go to a doctor who understands and is experienced with the nuances and challenges of rejuvenation of the ethnic face.  Though the topic may seem confusing, your doctor should simplify it for you.  
Good Luck, 
Dr. Karam

Susan Van Dyke, MD · Answer

I am so sorry that you had such a disappointing outcome from your CO2 laser treatment.   At this point it is important that you consult with a physician with a great deal of experience.  It is difficult to give suggestions without actually examining your skin.  Given that I can say that Fraxel Restore is very helpful and low risk for treating under eye wrinkles.  Loss of pigment and persistent redness after CO2 are much more concerning and difficult to treat.  Skin care options can help even out pigment and diminish red and brown discoloration.

Sam Goldberger, MD · Answer

Unfortunately, it sounds like you have had a bad experience with laser resurfacing.  CO2 laser is great for some skin types, but not for others.  Obviously, it wasn't good for you.  I would recommend that whatever you choose next, you do it very conservatively.  If further laser resurfacing is indicated I would treat very lightly and would proceed from there.  That way you can see how your skin responds.  More treatments may be necessary.

Confused About Laser Resurfacing Treatments After Disappointment with CO2

Answers (10)

Answer: CO2 laser requires expert hands.

Answer: CO2 laser requires expert hands.

Answer: Confused About Laser Resurfacing Treatments After Disappointment with CO2

Answer: Confused About Laser Resurfacing Treatments After Disappointment with CO2

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Confused About Laser Resurfacing Treatments After Disappointment with CO2

Answers (10)

Answer: CO2 laser requires expert hands.

Answer: CO2 laser requires expert hands.

Answer: Confused About Laser Resurfacing Treatments After Disappointment with CO2

Answer: Confused About Laser Resurfacing Treatments After Disappointment with CO2

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Everything you need to know about Laser Resurfacing

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