5 months post-treatment in North Carolina

I has been 5 weeks now. My skin tone is still not completely uniform, but is slowly, slowly evening out. I may have a little hyperpigmentation on my temples, but I had another plastic surgeon (a friend I saw at a conference) look at my face and he said he didn't see anything that concerned him. Said it can take a while to heal when the treatment is aggressive and to just be patient. I've continued to find milia, especially on my chin and cheeks. Had a follow up visit with my RN and she suggested a chemical peel to speed along the process of evening out my skin tone and helping with the milia. I had the peel done 4 days ago. My face started shedding last night and so far, so good. The new skin that is starting to appear looks even and smooth. I will update again after I am done shedding.

It has been 9 weeks since I had my fraxel treatment so I thought I'd provide an update. Overall, with regards to scarring and melasma, I would say my skin looks slightly better in some places, worse in others. Either way, I still have to wear makeup daily and I'm out the money. I actually didn't have fraxel, which is a brand of laser, but had fractional laser treatment with a Palomar laser (sorry, not sure which model or setting). At this point I would have to say that it was not worth it. A month after the procedure I still had some redness and what appeared to be mild hyperpigmentation. My RN suggested a medium chemical peel which was a combination of Salicylic 30%, Glycolic 40% to 70%, modified Jessner 14%, Alpha Beta 17%, and Retin A. This helped tremendously with the hyperpigmentation and helped some with all the milia that formed as a result of the laser. However, there are other results of the laser I should share. First, this made my acne come back with a vengeance. I struggled with mild to moderate acne throughout my teens into my early thirties but finally had it controlled for the last 10 or more years. I would recommend if you are acne-prone you might want to consider other options, like perhaps a chemical peel which actually helped clear the acne and milia the laser created. Second, the laser treatment resulted in the reappearance of old scars. I opted for laser to treat melasma and mild acne scarring. The scarring which I had is mostly still there, in addition to some old scars which had faded and were no longer really noticeable. Third, I have some new scars from the treatment, two or three tiny ice-pick scars, a scar type which I have NEVER had before. Fourth, the texture of my skin is different now, might be what others have referred to as orange peel, though mine is not consistent everywhere but is rough in patches. Finally, I can still see the tiny grid pattern in some areas on my face, especially around my chin and mouth, and in some places on my cheeks and temples. I am beginning to wonder if this will ever go away as I am now into my third skin cycle since the procedure.

I don't want to sock it to my RN, so I will try to be fair. She seemed very knowledgeable and her bedside manner was great. However, she did not go over the consent form and explain or elaborate on the potential side effects. She simply gave me the form, let me read it while I was numbing, and asked if I had any questions about it. Right before the procedure she asked if I wanted to treat a little more aggressively, which she said would result in more "down time" but with greater results. She never said the potential risks would be increased as well.

I am not on a mission to scare anyone, as some others on this site have done. I think this may be a good procedure for some, depending on their skin type and the skill of the person treating them. I would recommend, as others have, to research your facility thoroughly, and make sure you are being treated by a certified plastic surgeon, NOT their tech, and make sure they have done LOTS of these procedures. You don't want to be the 5th person they've ever treated. Also, I wouldn't recommend going to a regular MD who has obtained the certification but is NOT a plastic surgeon. I've noticed that those in the industry seem to really push the low amount of down time from laser treatment, as if you can go right back to work with what looks like a sunburn. This might be possible with a very low setting, but was not what I experienced. I looked like a swamp beast for several days so the immediate reaction to the laser can vary widely from one individual to the next. Plan on at least a week before you're ready for public display if you want to be on the safe side. I would also recommend insisting on a patch test, and if that works out ok I would then recommend a low setting treatment and only moving forward with more aggressive treatments if you are getting positive results.

I will post again if I notice any other changes over the long term, whether good or bad.