Will laser cause hyperpigmentation?

I'm planning on getting fraxel dual as one of my treatments for my scars.I have slightly raised scars on my chin and rolling scars on my cheeks. All of my scars are reddish brown and the acne has been gone for 2 years now. My concern is that I might get hyperpigmentation from the laser because I have hyperpigmentation from acne? Is it also true that laser is more effective on younger people? I'm 17. Also is fraxel more effective on my forhead scars?

Doctor Answers 5

Will laser cause hyperpigmentation

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Thank you for your question. Post Hyperpigmentation risk depends a lot on your skin type and past issues . Without seeing the scars and knowing your skins risks to repeat the problem it is hard to say. Consult with a Board Certified Plastic Surgeon for the treatment plan that is best for you.

Why hyper pigmentation from lasers is a valid concern

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Skin with more natural pigment is at higher risk for post treatment pigmentation following laser treatment.


Skin often responds to injuries and inflammation with additional pigment formation. You have seen that in your own skin from the inflammation your acne caused.

Lasers "intentionally" injure the skin to force new collagen production. In the course of that intentional injury, there is heat and inflammation - both of which cause pigmentation.

It is highly likely that laser will cause more pigmentation - though it would probably be more diffused.

There are other options for the treatment of scars - eMatrix uses radio frequency instead of laser, and the heat it induces does not pass through the skin layer that contains melanin cells like laser heat does. But there is still some risk of pigmentation. You can pretreat and post treat with melanin suppressors (like hydroquinone, arbutin and others).

Or, you can take a different approach with microneedling combined with pigment suppressors. Microneedling does not utilize heat so you've pretty much bypassed the pigmentation problem that lasers or heat based procedures can cause skins that tend to pigment easily.

With microneedling (now mostly done with automatic pens) you may still get some inflammation, but co-treatment with melanin prevention products and the non-heat nature can help with both the depressed scars and the existing pigmented scars and further reduce post treatment pigmentation issuse. It won't be a quick process, but young skin does improve faster.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Side Effect from Fraxel lasers

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Fraxel is a fabulous laser for treating acne scars.   However, if you have a tendency to hyper pigmentation, you might want to discuss a test spot with your dermatologist .  Depending on your skin type the eMatrix laser might be a better choice for you to treat the scars.  Please consult a board certified dermatologist who has a great deal of experience with acne scars and lasers.

Hyperpigmentation after the use of lasers on the skin

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Great question and observation. If you develop hyperpigmentation from acne, the likelihood that you will develop similar changes in the skin is greater. Inflammation, irritation, extreme heat or cold, and burns to name a few, can cause discoloration to the skin. I would advise having a test spot performed before you get the actual procedure. Depending on the procedure, all ages can do well and respond to laser procedures.

Cheryl M. Burgess, MD, FAAD
Washington DC Dermatologic Surgeon

Hyperpigmentation from lasers is usually a problem in darker skin types

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You didn't mention you skin type. Hyperpigmentation usually occurs in the darker skin types. Pre treating with hydroquinone helps prevent this. I like the Infini for acne scars because it has a very low risk of pigmentation problems.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.