Can a Dr test a hidden part of my skin with a laser before a resurfacing procedure to see if it would cause hypopigmentation?

You can do test spots before laser treatment. There is a big difference between a test spot and resurfacing your entire face. That should be discussed with the treating physician.

Test spots are an excellent way to see if laser resurfacing is appropriate for your skin type. It can also help you determine the length of recovery time needed. Best, Dr. Karamanoukian Los Angeles

Thank you for the great question. Darker skin tones are at higher risk for post-laser irregular skin pigmentation. Although the erbium laser is one of the most effective and safest lasers on the market, it is best to perform patch testing when a patient has darker skin color. To help avoid this complication, pre-treatment with Hydroquinone 4% and with Retin A for a few weeks is advisable. Post-treated skin should be protected for several months with UV protection. I hope you find this helpful.

Currently the most common type of laser for resurfacing the skin is the fractional co2 laser. It is very safe and complications of hyper/hypo pigmentation are rare. If you have a darker skin color your risk is relatively higher than a whiter skin color. I have in the past test spotted the laser on certain patients that are darker such as middle eastern. Also I have made a decision not to laser someone based on the test patch. You do have to wait at least 6 weeks to tell if there would be prolonged huperpigmentation. please consult with a physician experienced in laser skin resurfacing. 

Hello, and thank you for this questions. Yes we can go ahead and spot treat an area to see if the patient would develop hypopigmentation. This is very uncommon with the newer fractional lasers. I would recommend she seek out a qualified board certified plastic surgeon and/or dermatologist in your area has experience and expertise in laser treatments. Best of luck.

Hi Thomas.  We do not offer test patches because they are not meaningful.  Current fractional technologies (especially the Erbium fractional we use) have largely eliminated the risk of hypopigmentation.  If that issue were to arise, it would be likely that the laser was being used in a way that was not consistent with current practices.In addition, test patches are not necessarily conducted on the area to be treated or at the same settings.  I let my patients know that if another practice is willing to do test patches, then they are likely not confident in their ability with the laser.Check below for before and after photos of Los Angeles fractional laser resurfacing.

Hypopigmentation is not an issue with any lasers these days unless they are not used properly or are fully ablative.  Fractional devices almost never cause this, its hyperpigmentation that you have to worry about.  I used to test patch, but it is never accurate.  If you test an area that is hidden, it does always respond the same as an area that is sun exposed or visible.  Also, it takes 3-6 weeks to know if hyperpigmentation is going to occur and 3-6 months to see hypopigmentation.  You will be waiting a very long time for any response.  My suggestion is going to the best laser physician, fellowship trained , has many devices, specializes in lasers and trust them to give you the best treatments and skin care..  Best, Dr. Emer.

Although I do not think a test spot in a hidden area is 100% predictive of how other areas of skin will react I think there is value to it.  It can make a patient more comfortable with the process but it also can be informative to the doctor. I often will look at a test spot to see how reactive a patient's skin is in general. People can react very differently to the same laser settings so I think performing the test can give a preview to that individual's response. 

Hypopigmentation is almost always the result of total ablative (not fractional) laser resurfacing. It doesn't really occur with fractional lasers. It the laser burns the skin and is used improperly, you can get it with any laser and a test patch will do no good because the operator might do things right with that and wrong during the actual procedure.  I use test patches for dark skin types and laser hair removal with the 1064. This is really the only time I do it. Resurfacing lasers are not attracted to pigment, but to the water in the skin. I don't think a test patch would add any value to your decision making other than give you piece of mind.

Yes, test patches can be done on areas of skin. Most often I conduct test patches on skin conditions like birthmarks, especially in ethnic skin or if birthmarks are dark, or mixed with different types of blood vessels. As for general resurfacing, test patches are rarely informative as they do not represent the true nature of resurfacing- for example, the eye area is treated more conservative than the nose, and the lips and around the mouth different from skin on the forehead, eyelids, and nose. Most laser dermatologists and plastics do not do test spots for that reason. If you are uncertain as to the procedure, possibly a more conservative approach may suit you. Fractional lasers can be used as a stand alone, or combined with a superficial laser like Fraxel 1927. For patients who are nervous in regards to how their skin reacts, I think fractional lasers, as suggested by many, is the right step forward. All the best, Dr Davin LimLaser DermatologistBRISBANE, Australia.