Dear Dr. Seckel, I am 42 with major sun damage. I have fair skin, and no rosacea. I had 2 Fraxel procedures a year ago to remove sun damage. They were done 2 months apart. Now I am left with large dark brown patches on both cheekbones. They are very obvious. Even makeup cannot hide them. I am devastated. I’ve been using Tri-luma for 3 months with NO success. I am religious about applying sunscreen (Ti-Silc) and a hat for facial sun protection. Fraxel was very painful and had a long downtime. Is there any hope for me? IF IPL laser is suggested, is it painful? does it truly have no downtime? Thank you, Roxanne, NJ.
Dear Roxanne,
I am very sorry to hear of your problem with post-inflammatory hyperpigmentation following Fraxel laser. I have had several people write me with the same complaint but most of them have had dark skin, not fair skin like you. Fraxel web site lists pigmentation problems in 15% of patients.
I prefer to use the Obagi Skin Care System of topical creams to for pigment removal in patients with post-inflammatory hyperpigmentation, -it works very well. The IPL or photo facial is another effective treatment for hyperpigmentation and it is usually tolerated well by patients. There is a small hot sting but it is not considered painful by most who have it done.
By all means if you are going to have IPL or photo facial have the doctor do a small test patch to see the result before you have the full treatment done. It is also VERY IMPORTANT that whoever treats you have a lot of experience using IPl. I also recommend a newer IPL machine made in the past two or three years, the new machines are much better.
It is very unusual for the pigment to last so long. Sun exposure is usually the problem but it sounds like you are taking precautions.
I hope this helps.
For more information on pigment removal, fraxel, lasers, IPL, photo facial and non-surgical facial rejuvenation read Save Your Face or contact me.
Thank you
Boston, Massachusetts