Is this normal after pulse dye laser? (Photo)

Question

9 days ago I had pulse dye laser on a small port wine stain . I bruised terribly . They said use a heavy moisturizer . I did but also have been using vinegar rinsesive been taking great care of it .There is now a dent on my chin from the laser.Is this a normal process after PDL? I went to Derm 2 days ago to ask if this was normal and she said yes and said it looked fine.yet I feel concerned about the "pit"(on my right side) and the way it looks .will I scar ?What will fox the dent ? Thank you !

Jason Emer, MD · Answer

Unfortunately this was done way to aggressively.  was there coolant that fired? you got skin necrosis rather than simple purpura.  this needs topical wound care immediately with silicone based scar gel with growth factors and I suggest seeing a cosmetic dermatologist with experience in lasers.

Raffy Karamanoukian, MD, FACS · Answer

At this stage, I would use Plato's Scar Serum twice daily followed by fractional laser once the skin heals over. Best, Dr. KaramanoukianLos Angeles

Michael I. Echavez, MD · Answer

I do not know the details of the pulsed dye laser treatment to your port wine stain, but your recovery does not appear normal.  The worst that should occur would be some discoloration appearing like bruising.  The skin should not be damaged as it appears yours has been.  You need treatment tailored to the burned area.  I would consider getting another opinion from another dermatologist or a facial plastic surgeon or plastic surgeon.

Hratch Karamanoukian, MD, FACS · Answer

Aggressive settings caused this to occur.It is more likely to get hyperpigmentation than hypopigmentatioon after pulsed dye lasers.
In general, Pulsed dye laser can cause bruising and swelling and I precondition and treat my patients with a bioflavonoid product called Swell-x pt (post treatment) and also an oral supplement for PIH relief called Scler-X and I find them to be effective. 
For hyperpigmentation relief we use a HQ and non HQ based creams in  the U.S. called Melarase.
Hratch L Karamanoukian MD FACS

Benjamin Caughlin, MD, FACS - Account Suspended · Answer

This is hard to answer without a good physical exam. The PDL laser with wavelengths ~ 590 range targets the hemoglobin in the vessels. It burst the vessels and that is why you typically get the dark bruise that evolves through the typical stages of a bruise. It also applies a significant amount of heat to the epidermis so a coolant needs to be applied simultaneously. If there is no coolant the skin can be burned slightly.

The "dent" can be there from the peri-lesion swelling and/or epidermal damage. There are many options to treat it from a scar standpoint if it persist. I would see your surgeon ASAP to discuss.

Hope this helps.

Best of luck,

DrC

The "dent" can be there from the peri-lesion swelling and/or epidermal damage. There are many options to treat it from a scar standpoint if it persist. I would see your surgeon ASAP to discuss.

Hope this helps.

Best of luck,

DrC

Is this normal after pulse dye laser? (Photo)

Answers (5)

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