Will Fraxel Leave my Skin Looking Darker?

Question

I saw a youtube video were a lady showed how much darker her skin looked even a month after treatment with Fraxel.
I'm hispanic, and I have had other lasers for the treatment of brown spots. My skin is so sensitive to irritants that the lasers made the spots worse.  I'm considering having Fraxel done on my face, but I'm a little scared that my skin will stay darker and the spots won't go away. 
How can I tell if Fraxel will make my skin darker?  Is there a less risky treatment for removing brown spots?

Ron Shelton, MD · Answer

Unfortunately, all treatments for dark spots in dark-skinned individuals, and light-skinned patients too, have a risk of creating post inflammatory hyperpigmentation…or in other words the pigment of the skin reacts to the treatment by dropping the pigment cells or melanocytes in the dermis under the epidermis. This can leave you with a temporary darker coloration, which may be splotchy. Especially after individual spots are treated with pigment specific lasers rather than treating the whole face. The darkness can take months to even a year or more to subside, rarely it remains. Multiple light chemical peels and prescription lightening creams often reduce the color but this is a risk, including with Fraxel and other lasers and thermal devices. The Fraxel Restore is the best laser for helping dark coloration in dark-skinned individuals but there still is risk. Consult with a knowledgeable and conservative physician before agreeing to do the treatment. Sometimes, a test spot can be done. If the test spot darkens and doesn’t get better then you don’t want to do the treatment. If the test comes out OK, it doesn’t guarantee, however, that you won’t get a bad result.

Sanusi Umar, MD · Answer

Hispanic skin is fine for Fraxel treatments, but you definitely want to proceed with cautious. Treatment could possible darken your skin, which I know you probably would want to avoid. Darkness can last for up to 3 months, so again, you want to be really careful. The main thing I want to see you avoid is post inflammatory hyperpigmentation. Fraxel Re:store is by far the best option for treating dark-skinned patients. You should ask your doctor if he or she is willing to run a test on a small patch of your skin before hand.

David Goldberg, MD · Answer

Fraxel can be used to treat brown spots on Hispanic skin. In general, though, there are better lasers than Fraxel for this, including the Q-Switched Ruby, Q-Switched Alexandrite and Q-Switched YAG lasers. In addition, a variety of intense pulsed light (IPL) sources can be used to treat brown spots. Although a Fraxel laser will lessen the darkness of brown spots, it’s a much better laser for improving the quality of skin and wrinkles than for treating brown spots.

Usha Rajagopal, MD · Answer

Fraxel can make your skin darker. To help prevent or minimize the darkening of the skin, skin care treatment of Retin-a and/or Hydroquinone should be utilized before and after Fraxel Treatment. If it does darken, it will take anywhere between 1.5-3 months until the “darkness” goes away.

Will Fraxel Leave my Skin Looking Darker?

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