Red small dots/marks on my nose - What should I do?

Question

Hello! A month ago I did fractionated laser treatment (ablative). My skin was very clear, I only had some scars I wanted to get rid of. But no acne. Now, after a month, my skin is still pink and I have started to get some pimples (which I dont use to get). My nose have a lot of pink small marks/dots that came up out of nowhere. I have already talked with doctors about these marks on my nose but they dont really know what it is. I didn’t have them before. Would really appreciate your help!

William Groff, DO · Answer

Thank you for your question and photos. Unfortunately, it is difficult to get an accurate idea of what the dots look like based on the photos you provided. I can tell you that inflammation and pigmentation marks are common after fractional laser treatments, particularly ablative procedures. It is possible your skin is still in the healing cycle. However, I encourage you to schedule an assessment with a board-certified dermatologist who can evaluate you in person and determine whether additional treatments might be needed to address this symptom.

Jason Emer, MD · Answer

Hyperpigmentation and inflammation after laser procedures is quite common. In general, hyperpigmentation of any kind needs a combination approach of peels like Cosmelan, lasers like Clear + Brilliant, Aerolase and Laser Genesis, radiofrequency treatments like Venus Viva, and constant skin care and sun protection. Bimonthly facials with SilkPeel / DermalInfusion are essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. I suggest getting a formal evaluation with an expert in lasers and peels. Best, Dr. Emer.

Yelena Kipervas, DO · Answer

Hi there. So the fractional targets CO2. Usually the laser technician adjusts the machine settings accordingly to your skin type. Now it is very important the aftercare you are following when you are home. You should avoid harsh soaps and exfoliants for 2 weeks and use mild cleanser only.Sometimes the food you eat or the laundry detergent you use can irritate also. Some other times it may be that your skin is very sensitive and cannot tolerate this type of procedure. Good luck

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and photos.  It appears you are very young.  What the skin does during recovery depends on your general overall health, skin type, post-laser treatment regimen, and your expectations.  It would be helpful to know what you mean by ablative fractionated laser- it could have been an erbium laser that is a bit more superficial, or it could have been a CO2 laser which is a deeper penetrating type of treatment.  Both can be useful for acne scars.  I would recommend going back to your dermatologist who did your treatment and have an in -person evaluation and discussion of further care including maybe a topical antibiotic or retinoid to avoid future acne, and maybe some microneedling for more improvement.  Best of luck!

Awfa Paulina, MBChB · Answer

Ablative fractional Laser will cause small burns to the skin, and generate new collagen, some people will be more pink in the healing process, I generally recommend anti inflammatory topical application

Red small dots/marks on my nose - What should I do?

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