Is Orange Peel skin after laser permanent? My face is an orange Peel texture now. What happened?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Dear notworth,

Rough texture after fractional laser resurfacing, including
the Fraxel DUAL can be anticipated.
Rough texture occurs because the fractional ablations create very small
defects in the surface of the skin called the epidermis and dermis and these
need to be remodeled over time. The
Fraxel DUAL can be a very superficial and gentle fractional resurfacing or
deeper and more significant. For deeper
fractional resurfacing I always warn patients that the end game of the
fractionated laser resurfacing is to remodel the dermis “under carpet” of the
skin with new collagen and Elastin, but this takes time. Reepithelization or coverage of the
microscopic fractional craters occurs within 24-72 hours, however, remodeling
of the dermis itself that was injured with the fractional technology may take
3-6 months. During this time very gentle
microdermabrasians or chemical stratum corneum reduction techniques can help
the process along as can synergistic treatment starting at 6 weeks with intense
pulsed light and bulk heating non-ablative radio frequency treatments such as
the Forma, Venus Freeze and Exilis.

I would certainly go back and see your operative physician to
get reassurance and possibly entertain some of these adjunctive
treatments. In rare circumstances after
aggressive fractional laser resurfacing some long-term fractional
irregularities or rough texture can ensue and the treatment for this is more
gentle fractional treatments to improve the skin texture.

I hope this information has been of some assistance and best
of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto