Fractional laser - CO2 or Erbium? Plus PLH help! (Photo)

Question

Had first ever aesthetic procedure, this was with an aesthetic doctor. Agreed CO2 fractional laser was way to go for minor old acne scarring and early signs of aging. Tx details: fractional laser e720j, single, 3x density, 0.8mm AND KTP532nm Question: this has left me with terrible hyperpigmentation in the shape of the stamp on cheeks and jaw line. Worse in areas which were super sore during procedure. What are your thoughts on choice of fractional CO2 laser settings? KTP seems to be erbium?!

Anna Chacon, MD, FAAD · Answer

When it comes to choosing between fractional CO2 and Erbium lasers, both have their specific benefits depending on the skin condition being treated. CO2 lasers are typically more aggressive and are often used for deeper resurfacing, which can be effective for acne scarring and signs of aging. However, they also have a higher risk of side effects such as hyperpigmentation, especially in individuals with darker skin tones.

The settings you mentioned—fractional laser e720j, single, 3x density, 0.8mm—indicate a relatively intense treatment. The "stamp" effect and subsequent hyperpigmentation you're experiencing might be due to the high density and energy settings used, which can lead to more significant skin trauma and a higher risk of post-inflammatory hyperpigmentation (PIH), particularly in sensitive areas.

The mention of KTP 532nm suggests the use of a different laser wavelength, often associated with vascular treatments or superficial pigment. It's possible there was a combination treatment approach, but it's important to clarify with your provider.

For managing the hyperpigmentation, consider the following options:

Topical Treatments: Use topical agents like hydroquinone, azelaic acid, or retinoids, which can help lighten hyperpigmented areas over time.

Sun Protection: Ensure diligent use of broad-spectrum sunscreen to prevent further pigmentation.

Consultation: Follow up with your dermatologist to discuss your treatment's outcome and explore additional options like chemical peels or less aggressive laser treatments for addressing PIH.

Time and Patience: Hyperpigmentation can take several months to improve, so patience and consistent skin care are key.

Always consult with a qualified dermatologist to tailor the treatment to your specific skin type and condition, and to address any complications swiftly.

Fractional laser - CO2 or Erbium? Plus PLH help! (Photo)

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Fractional laser - CO2 or Erbium? Plus PLH help! (Photo)

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