Dear Dr. Seckel, I have had a series of fraxel treatments for melasma.I am very faired skinned and have melasma on both sides of my cheeks and down the jawline. After 5 treatments, a study, and 2 others at a higher strength with more pass, the result is worse than what I originally had. Skin is darker and the where the laser treatments were performed, the miasma appears to have spread. What do I do now, out of money and have worse darkening than when I started this treatment. Any advice greatly appreciated, thanks, Tracy, Vancouver, BC
Tracy,
I am surprised to hear of you difficulty following Fraxel laser treatments–Melasma has been the one condition that Fraxel laser skin rejuvenation has been most successful with. There is a reported 15% incidence of post-inflammatory hyperpigmentaion that is brown spots, after Fraxel, but that usually occurs on darker skin. Hopefully your Fraxel post-inflammatory hyperpigmentation will resolve in time.
My aestheticians all (5 of them) agree that the best treatment for pigment removal of melasma or post-inflammatory hyperpigmentation after Fraxel treatmentys is to start the Obagi (prescription) skin care program–a series of strong topical creams including Retin A and hydroquinone–it always makes the pigment better–if you stop the cream it comes back. Some knowledge is required-see if you can find a doctor familiar with the product usually a plastic surgeon or cosmetic dermatologist. I also do a series of microdermabrasions while on the Obagi program.
After the above and a waiting period of 3-6 months after Fraxel there are other options to try. A new laser by Palomar called the Lux1540 which is the Palomar answer or Fraxel type laser has had success with pigment removal. Another ablative fractionated laser similar to Fraxel, the new ablative fractional laser peel called the ActiveFX laser skin peel can help-but do a test area in a small spot of pigment first.
You should email Reliant Technologies they company that makes Fraxel about your experience with Fraxel treatment for melasma–they tout Fraxel as the best treatment for melasma.
The reports I have heard so far about Fraxel is that Fraxel works well foer pigment removal and acne scars. The 15% incidence of pigmentation following fraxel is known, and can be treated. I dont have a fraxel but if I did I would test a patch of hidden skin behind the ear first to see if pigmentaion was a problem after fraxel treatment.
For more information on pigment removal, lasers and non-surgical facial rejuvenation read Save Your Face or contact me.
978-369-4499
Boston, Massachusetts
Concord, Massaxchusetts