Thank you for your question. I understand you underwent erbium and CO2 laser about four weeks ago, and now you’re concerned your skin is ruined because it is now leathery, shiny and bumpy.To first give you a bit about my background — I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I have used the CO2 laser, erbium laser and fractional CO2 laser in my practice over this time as well.Now, when it comes to wound healing, there are four phases: the hemostatic phase, inflammatory phase, proliferative phase and wound-remodeling phase. At the time that you submitted your question, which is four weeks or one month after the procedure, you’re at the proliferative phase. The proliferative phase is the phase where a lot of blood supply and collagen are being formed. In the mid-90s, when the CO2 laser was first introduced, it was not unusual for someone to have fairly intense redness that lasted for months. In your case, it is possible that the indication for you had to be aggressive, which is why you’re seeing these symptoms.In some cases, it might seem like there is excess redness or excess bumpiness, and this is the art of medicine - what may seem excessive to one doctor, may seem expected to a more experienced doctor. There is also often a challenge when it comes to reviewing photos because the situation can sometimes look worse in photos than they do in person, perhaps because the reds tend to be more intense and look more vivid than they do in real life.You can modulate some of that inflammation with the help of topical steroids or other modalities such as platelet-rich plasma (PRP), which can really diminish a lot of the initial redness. But in the absence of a proper physical exam, it’s hard to say whether or not you are suited for it.I recommend that you meet again with the doctor who performed this procedure and tell them your concerns about your results. Your doctor should be able to tell you if this is normal healing or not, and if there is unusual inflammation, then they should be able to recommend a topical steroid to help. In rare cases, redness can also be a sign of infection, but that is not necessarily the case, especially if someone is watching over your progress. Keep in mind however that based on these photos, you will get a lot of conflicting opinions from different doctors, should you seek their advice, so you have to be sure that you aren’t being over treated.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
