Fraxel Laser Dual for Melasma and Scars - San Francisco, CA

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I am a 41 year old Asian female. I have always...

I am a 41 year old Asian female. I have always had good skin and complexion. Over the years and after two pregnancies coupled with being on synthetic thyroid hormones, I have developed some light melasma on my cheeks. These darker marks could easily be covered when I wear makeup so I never gave much thought about removing them. About a year ago, I had an insect bite that I at first thought was a mosquito bite on my left cheek bone, right under my eye. This left a scar when it healed about the size of a pencil eraser. I went to see my dermatologist about this mark and learned that Fraxel is about the only thing that could really lighten this. My dermatologist also noticed the melasma I have and recommended the Fraxel Dual since I am Asian and have olive tone skin.

Day of Treatment and After Procedure

To prepare for the procedure, numbing cream was put on my face for about 1 1/2 hour before the actual procedure. The numbing cream was then removed and wiped away. My doctor opted to be conservative since I had concerns and was nervous about my sensitive skin. He told me I would be treated with only 4 passes (2 passes of each of the laser type).
My eyes were covered and he began to apply the laser over my face. There is a slight prickly sensation that is uncomfortable. With the numbing cream this was tolerable. The 2nd pass was a bit more uncomfortable and I felt the prickly sensations more. During the procedure, I could feel that areas that were not covered well by the numbing cream earlier felt more painful and was a lot more sensitive to the laser. My upper lip was also less tolerant of the laser. Over, with each pass, the level of pain seem a tad higher. Given that I have very low tolerance to pain, I felt I tolerated the procedure well overall and it was doable and bearable.

Post Procedure
Immeidately after the procedure, I could feel some throbbing in my cheeks and I felt flush. No painful sensation other than feeling really warm on my face. I was a bit swollen under my eyes and my face looked flushed as if I just had a jog. I was immediately given a cooling mask to wear for 15 minutes as I lay on the table before leaving. After the cooling mask, sunscreen and a petroleum based lotion was applied to my face. I did not feel any major discomfort. I was informed that over the next couple of days, I may experience redness and swelling but that it would subside and my complexion may bronze and look like a sunburn.

12 hours later in the evening, my face still feel hot and I am applying the lotion. My face has really become red and it now looks like I was in the sun with swimming goggles and have a sever sunburn. The numbing have complete gone away so I can feel some tenderness in my face. Some swelling under my eyes in the cheekbones. Otherwise no pain or discomfort. My face feels really dry and I want to constantly put a cool towel over it.

Day 2 Post Procedure
I woke up this morning feeling like my face is cracking. I clean my face and apply the lotion. My face is red and my entire face is puffy and still warm to the touch. The red is now a darker settled a sunburn alright. The texture of my face feels like sandpaper. I can also see "pixels" on my face that looks micro scabs.

Day 3 - More Swelling and Redness

On Saturday, I woke up feeling like my face was retaining water and I dreaded looking into the mirror. Sure enough my face has swelled and the color is best described as "angry" red. My doctor had told me to expect the redness to turn darker and bronze but this is not bronzing. My face also feels hot to the touch. I spent the day using cold towel compress and applying the lotion I was given. I start taking Benadryl hoping to reduce the swelling. By mid-day the swelling seems to improve even though I still looked like a chipmunk. At end of the day, as I am washing with the gentle cleanser, I notice some sloughing of the skin. Some areas seem to be rubbing off and the micro pinhead scabs are rubbing off. Under the areas where the skin sloughed off, I can tell it's clearer. But the redness makes it so hard to gauge. I also refrained from rubbing or scrubbing because I don't want to make anything raw. My forehead area seems to be healing much faster than my cheeks. This area is visible bronze like a tan and not red. The redness is from the bridge of my nose and my cheeks.

Day 4 - Swelling Down Still Redness

I am noticeably less swollen today. Still red but less angry shade of the color. After the morning cleansing, both of my cheeks have completely lost the scabbing. It looks perfectly smooth and I can't see the brown melisma spots. I am really worried about this redness as I have to return to work next day. I tried applying make up to see if I wil be able to go out without looking weird. Nope. I look superweird because even under makeup, my face is two colored. Spent the day cooling my face, applying lotion. By noon, I'm noticing that I'm my face is itching and this is unbearable. Adding hydrocortisone to the lotioning. Helps very a bit but not enough to not touch my face every 5 minutes. To me, this is the most unbearable part -- red and itching. I'm frustrated that the redness in my cheeks does not seem to diminish in area. Through the day, I think I see the redness diminish but I'm not sure if I'm just seeing what I wish as it looks more red at times. I'm drinking lots of water, using cold towels to feel less hot and lotioning but I'm still red and itchy with no end in sight. Feeling depressed and anxious.

Sunday evening, after waking from a nap, I notice my face feels less hot. I go to the mirror and the selling has gone down where I no longer appear puffy cheeked. The redness has gone down and I although still red, it does not appear angry. It just looks flushed like a normal sunburn and not a severe sunburn. I am relieved that the redness seems to be improving. By now all the scabbing and top layer have sloughed off. I don't see the melasma areas. The scar from the insect bite is now a pink dot. I feel hopeful and can't wait to see what the results are after the redness completely goes away.

Monday - Day 5 and much of the same

The redness is what bothers me the most at this point. I am not peeling anymore so the texture of my skin is perfectly smooth. I didn't have large pores and what pores I did have around ear my nose seems to have disappeared. I can see even though I am still red that my melisma have diminished significantly. The two patches on my cheeks are gone as I look in the mirror. Just trying not to be too optimistic and see what happens after all the redness subsides. I went to work under makeup today. I just looked as if I went skiing and completely forgot to wear sunscreen. I basically just said I had a facial procedure and I'm still healing and everyone was fine.

A week post procedure - Yay! redness subsiding

I have noticed that the bandryl pill helps with the redness and itching. Last night before bed, I opened a vitamin E capsule and applied the vitamin e lightly on my cheeks. When I woke up this morning, the red is noticeably gone. I am still flush looking but this shade of pink can be covered by makeup and I look like I'm just wearing blush. I see no melasma on my cheeks -- both small quarter patches are gone. My scar from the bug bite now looks about the size of a half a rice and it's no longer that brown scar pigment but rather a pink mark. The broken capillaries red marks are GONE. I feel so happy because it feels like all that red and itching was worth it. I still have some itching and light flaking but nothing noticeable to others but me. I would say as of today that I am very happy with the outcome. HOWEVER, I will not be doing any further sessions. This will be my one fraxel and I'm glad it took care of what I wanted.

All in all, I feel my $1200 spent was worth it. I think Dr's should set the correct expectations of healing time and what to expect. Be prepared for a whole week before looking remotely normal. If you have sensitive skins, allow more time. Then be prepared for the discomforts. I was given Valtrex ahead of treatment to prevent any breakouts. I was told about expecting my face to be a funny color. I just wasn't prepared that it was going to be a whole week so I was inpatient.

I will try to post some pics of the whole process.
Ken Masuoka

4 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
4 out of 5 stars Time spent with me
4 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
4 out of 5 stars Wait times
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