A: Fraxel Dual is an option to improve irregular pigmentation of the face and body, but I need to make a few points. First, if the depigmentation is from sun exposure or from old acne scars, the Dual helps by lightening the surrounding sun damaged areas with INCREASED pigmentation so the skin blends better. Unfortunately, once pigment is destroyed by sun or trauma, there is no reliable way to get it back. Lastly, you need to be sure to see a board certified dermatologist in order to get a correct diagnosis of the pigment loss. Sun damage is not the only cause of irregular pigmentation. It could be the result of something as innocuous as tinea versicolor, or as potentially serious as vitiligo. Accurate diagnosis should always precede treatment courses.
Q: How long does Fraxel last? I realize it may depend upon the laser, skin type, age, sun exposure. Is this something I need to do annually?
A: That is an excellent question. It is very important to be on a maintenance skin care program after fraxel to maintain the benefits longer. Daily sunscreen, all year round is key. Evening retinoids, bleaching agents and growth or other peptides will all prolong your benefit. Most compliant patients feel they need another Fraxel in 2-3 years.
Q: I have a lot of brown spots on my face as well as acne scars from years ago. I have an Asian and white heritage. Is there a safe option for me? I have a friend with similar skin who now has a white hue to her skin after getting some kind of laser.
A: My guess is that your friend had a rather aggressive resurfacing with a carbon dioxide laser. Delayed loss of pigment was a rather common complication. It was less noticeable in white patients, but Asian and Hispanic patients often suffered with the irregular pigmentation.
I recommend Fraxel Dual for your situation. The 1550 nm wavelength helps the texture and scars and the 1927 nm wavelength improves the blotchy pigmentation. Patients typically need 2 sessions of both (that is why it is called Dual) to give best results for mild acne scars and more severe pigmentation. More treatments at a more aggressive setting of just the 1550nm laser may be needed if the scars are severe. I have been using the Fraxel now for almost 5 years and have been pleased with the results as well as the safety for ethnic patients.
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