Outlined Squares After Micro Laser Peel

Question

Is it normal to have horizontal and/or outlined squares on the face after a 50 micron Micro Laser Peel? They started off bright red immediately after my skin peeled, turned pink days later, and are now beginning to hyperpigment despite the use of hydroquinone. Was this the result of operator error (technique, settings, etc) or simply the way my skin healed? Most of my face is fine, it's just certain areas that have these marks. Should I start looking for a different PS?

Stephen Weber MD, FACS · Answer

This can occur. Usually the geometric pattern of the laser is overlapped such that there aren't any intervening bridges or entirely untreated skin. It is possible that the treatment areas were not overlapped where you see boxes. This will likely settle over time and not require additional treatment. However, it is possible to go back and treat those areas if they persist after healing to provide a more uniform appearance. Stephen Weber MD, FACS

Jacque P. LeBeau, MD · Answer

The outlined squares should be confluent over most of the face after a full face 50 micron laser peel but you may have some areas with defined squares not touching the others.  This is due to the way the scanner on the laser lays down the pattern and it is up to the operator to make the patterns slightly overlap one another to obtain a uniform treatment.

	I would return to your provider to assess the areas which you believe may be hyper pigmentation so that the may be evaluated and addressed appropriately.  

	Best Regards,

	Jacque P. LeBeau, MD

Michael H. Swann, MD · Answer

Yes it is normal to have a geometric pattern of dots after any fractionated treatment.  The ablative energies utilized, pulse duration and density (how far the dots are separated) are the important parameters for long-term results, but the dot pattern in the skin can vary.  Some areas of your skin will peel more slowly and show the dot pattern for a longer time, which initially makes the treatment look irregular, but the long-term results are more based on the density used across the whole face.

	If you think an area was missed and you have an area of intact skin that did not peel, you should contact your laser surgeon for examination of this area.

Peter A. Aldea, MD · Answer

Microlaser Peel is a FANTASTIC facial procedure. The Sciton Joule laser allows very accurate removal of precise layers of the skin with a very short down time.

Not having been in the room during your procedure, no one can tell you what happened and why you have these squares. If I had to guess, I think whoever operated the laser did not superimpose the areas of treatment leaving a tiny bridge between them. Since a 50 micron MLP removes that precise thickness of the outer skin, by not making sure the target areas are touching (ie 50 microns are shaved off without leaving untreated areas). 

I would give this 2-3 months to heal and in the vast majority of cases such irregularities will improve without further treatment. If they do not, you may need a touch up Microlaser Peel .

Dr. Peter Aldea

Edward Lack, MD (retired) · Answer

Laser peels can leave pigmented boxes in treated areas. These usually disappear with time or can be improved with a combination of Retin A and lightening agents.

Outlined Squares After Micro Laser Peel

Answers (5)

Answer: Horizontal Squares after Microlaser Peel

Answer: Horizontal Squares after Microlaser Peel

Answer: Laser peels can leave pigmented boxes in treated areas

Answer: Laser peels can leave pigmented boxes in treated areas

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Outlined Squares After Micro Laser Peel

Answers (5)

Answer: Horizontal Squares after Microlaser Peel

Answer: Horizontal Squares after Microlaser Peel

Answer: Laser peels can leave pigmented boxes in treated areas

Answer: Laser peels can leave pigmented boxes in treated areas

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Recommended reading

Everything you need to know about Laser Peel

Our mission is to create a world where every investment in modern beauty is Worth It.