What order should I get Vbeam and Fraxel in?

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

vbeam can be performed with any lasers. Fraxel is NOT good for Melasma, but halo or clear and brilliant are. combine with Aerolase and cosmelan/enlighten peels.

Hyperpigmentation from any type needs a combination approach of peels like cosmelan,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

I would avoid using Fraxel for melasma treatment. It can make the pigmentation worse. Medical grade skincare, sun protection, chemical peels, and gentle lasers like Clear + Brilliant Permea are all part of my approach to treating melasma. As for broken capillaries and redness, the Vbeam is a great option.

I treat a ton of melasma and I would warn you against doing the Fraxel laser for it.   While initially it may appear better, it later gets hyperpigmented and is very difficult to treat then.   I would recommend the V-Beam laser first and then Cosmelan medical grade peel to treat the melasma. Please read about Cosmelan and the side effects of treating melasma on my web site. Best, Dr. Green

Although it technically does not matter, I always recommend treatment of the color first. I will clear the vascular in an initial treatment. In the second session if there is anything left, I will treat the vascular and then use my fractionated laser over top. Hope this answers your questions