How To Get Rid Of Scars After Fraxel Laser?

Question

I had undergone Fractionated laser treatment in April at a Plastic surgeon's office, which left a prominent scar on my forehead. The area looks patchy and pigmented. I am very disappointed and the Dr is asking me to pay further money for it's treatment. I had already bought the package and paid 3000 for the package. Can anyone suggest how to get rid of them. I am using Obagi, retinA and bleaching cream. But, don't see much difference. I don't want to go back to him either. Thanks in advance.

Sanusi Umar, MD · Answer

I am sorry to hear about what happened. Topical treatments such the ones you mentioned will not be able to eliminate the scar. The scar tissue is made of thickly arranged collagen fibers that originate in the dermal layer beneath your skin's surface. Just for your own knowledge, there is another Fraxel laser system called Fraxel Dual which helps your skin develop new and normal collagen fibers to reduce the appearance of the scars. However ,you should certainly seek the help of another board certified dermatologist who can  make more specific recommendations.

Emily Altman, MD · Answer

From your photos it is not  clear whether all the pigmentary change is hyperpigmentation or whether there is hypopigmentation as well.  The laser procedure itself can cause pigment changes.  In addition to that any sun exposure to the treated area can cause darkening as well.  I usually warn my patients about any sun exposure for 2-3 months after a laser treatment.

	In addition, for my skin type IV and above patients, I have them use a sunscreen and a bleaching cream for a month before and a month after the procedure.

	Also, prolonged use of a hydroquinone can cause a paradoxical darkening of the skin, called exogenous ochronosis. That can happen as early as two months of using bleaching creams.  There are also new bleaching preparations that don't contain hydroquinone that may be helpful.  The first thing to do, though, is to establish what the reason for the pigmentation is. 

	I would recommend stopping the bleaching creams and scheduling a consultation with a board-certified dermatologist with training and experience in Fraxel treatments for the evaluation of the pigmentary changes.  Also, please use a broad-spectrum sunscreen daily to avoid further darkening of the skin.

Shawn Allen, MD · Answer

A misconception that exists among patients and doctors is that the fractionated lasers dont scar.  This is absolutely incorrect. Almost every laser can cause scarring, afterall they are lasers.  If indeed you have scarring from the Fraxel (which is a brand name and should be clarified if this was the CO2 version or not) then after seeing the plastic surgeon and if their attempts fail you may want to ask them for a dermatologist or another plastic surgeon to refer to who will provide another approach to your management. Again, anytime you have a complication, report it to your treating doctor then if you are not satisfied seek a second and third opinion as needed. Often times your treating doctor will know who is the best in the area to help and will be happy to help you be seen by them quickly.

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