Severe Orange Peel Texture after CO2 Laser. Is this post-laser milia? Scarring? (Photo)

Question

I got a fully ablative CO2 laser 7 months ago and have been struggling with a horrendous texture that appeared after and has seemingly worsened in the past 3 months. The skin is glossy/shiny. It has a rough texture with hypertrophic bumps everywhere. The skin doesn’t look like skin. I can only go outside at night. Is it post-laser milia? Is it scarring? Is it recoverable from?

Amy Y. Paul, DO, FAAD · Answer

Thanks for your questions and photos.  I am so sorry you are experiencing this skin change.  This could be an unfortunate outcome because the laser was used in fully ablative mode.  CO2 laser is much more safe and effective in fractionated mode, which lessens the risk of scarring significantly.  I would recommend returning to your treating physician and see if there are other procedures that could help improve the skin texture.  The original provider should be made aware of your skin changes so they can offer you some other options, possibly microneedling or some chemical peels, depending on your skin type.  Please see an expert and best of luck!

Connie Hiers, MD, FACS · Answer

You appear to have scarring from a laser treatment that was too deep for the area.  PRP injections might be helpful to help rebuild some collegen or XoFlo injections once released.

Severe Orange Peel Texture after CO2 Laser. Is this post-laser milia? Scarring? (Photo)

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