Still Burned in Day 4 Harmony Pixel Laser?

Optimal wound care is important after Pixel laser. In our office, we would recommend a combination of Elevase cream with ceramides + a short term use of a light cortisone cream to reduce inflammation and redness. Best, Dr. Karamanoukian Los Angeles

Although its hard to make an assessment without seeing you in person, the black dots that you describe may represent microthermal treatment zones.  These are microscopic columns of dead tissue that were irradiated by the Pixel laser, which makes a grid-like imprint on the face.  It is the laser destruction of these tiny zones of healthy tissue by the Pixel laser that stimulates new collagen formation and a skin healing response, resulting in newer, tighter skin with less wrinkles and usually a more even tone.  In addition, oozing and crusting is not uncommon after a Pixel laser treatment if aggressive settings were used.  Redness in the first few days after treatment are a given.  In general, patients should be instructed to keep the area moist with a thick ointment such as Vaseline or Aquaphor and not pick the scabs off after the procedure.  If these scabs appeared suddenly or seem to be spreading, it could be an indication that you have a secondary viral or bacterial infection.  I recommend that you follow up with the phyisican who performed the procedure for an in-person evaluation.