Am I a good candidate for Fraxel? I'm 21, and Hispanic between 4-5 skin type. (Photos)

Question

Naturally lighter skinned Hispanic, but have a deep farmers tan. Deep acne scars on checks from cystic acne breakout, and have had a history of hyperpigmentation. And all the scars and hyperpigmentation are new, I never had this problem before.

Benjamin Caughlin, MD, FACS - Account Suspended · Answer

We have a lot of ways to tighten the skin. The number one issues is typically sun damage and/or superficial fat loss. With the ablative lasers you need to be careful with post treatment hyper pigmentation.  We have developed a new series of treatments using abrasion techniques along with different wavelengths of light to target discoloration, fine wrinkles and shadowing problems.  Even fat transfer, fillers and other radio-frequency devices (we are loving the viva) are showing good promise in this field. 
The key is to be critical, be specific about what bothers you and we can use the many tools available to us to target that part of your anatomy. This can range from volumizers to superficial tightening techniques as I mentioned above.
Hope this helps.
Best of luck,
DrC

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Elliot M. Heller, MD · Answer

Fraxel is a laser skin rejuvenation treatment that resurfaces your outer skin, erasing imperfections. It also encourages the production of collagen, a protein found in connective tissue.The result is clearly visible lines, folds and wrinkles. Fraxel laser skin rejuvenation is a non-invasive technique that affects only about 20 percent of the facial skin exposed to it. The most common side effects of Fraxel laser treatment are swelling and skin redness, which should subside within a couple of days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. The risk of infection or scarring is very limited. You should stay out of the sun 2-4 weeks

Jason Emer, MD · Answer

A combination approach will give the most improvement. These types of scars need a combination of lasers, microneedling/prp, subcision and fillers. Co2 is the best laser for scars, but Erbium is a great alternative. It may take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Carolyn Jacob, MD · Answer

Generally speaking, Fraxel Dual 1550nm can be safely used on patients with IV & V Fitzpatrick Skin type for the treatment of acne scars. 4-5 treatments are typically performed to see full results. A consultation with a board-certified dermatologist can address your specific scarring and hyperpigmentation to determine is Fraxel is the best treatment option for you!

Shobhan Manoharan, MBBS, FACD · Answer

Fraxel, especially on the 1550 nm wavelength may be quite a useful tool for scars like yours, but so may other options such as pulsed-dye laser for the inflammatory component, and radiofrequency microneedling or heavier fractional CO2 laser (in experienced hands with the adequate preparation and aftercare).  Fillers and subscision can be useful to release tethering of scarring and volume replace also.  In essence, Fraxel is an option, but seek an experienced practitioner who can offer a combination approach to your scars.  Best wishes, Shobhan.

Am I a good candidate for Fraxel? I'm 21, and Hispanic between 4-5 skin type. (Photos)

Answers (6)

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