Question
Will Fraxel Re:pair clear acne on Asian skin?
Hi, I'm an asian male, between a 3 to a 4 on the Fitzpatrick scale. I have acne scarring as a result of the accutane I went on a couple of years ago. I have had seven fraxel re:store treatments in attempts to heal my scarring, but the results have been minimal. I have a few depressed boxcar scars and some rolling scars mainly on my cheeks, but I don't think I have any icepicks.
I am heading in for my 8th re:store treatment in a week or two. My doctor has offered the re:pair to me, but since he has never actually tried the re:pair laser before, I am a bit concerned. To me, hope seems to be dwindling as the days go by. I need to know if I should give the re:pair a shot or try any other options, whether it be temporary or permanent.
Since I have asian skin, the hyperpigmentation concern is a big one for me. Will fraxel re:pair work for me?
Answers (3)
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1
October 16, 2008
Asian Skin Acne Scarring and Fraxel re:pair
Board Certified
Facial Plastic Surgeon
Facial Plastic Surgeon
Answer by Michael A. Persky, MD
Hi Hernis,
Fraxel re:pair should work for you given your description of your skin. I agree with Dr. Weiner that you should use hydroquinones before and after your treatment to minimize the chances of PIH. Good luck and be well.
Dr. P
2
October 16, 2008
No, it won't. You have learned the hard way that acne scarring isn't usually helped by lasers
Having used lasers ranging from the older CO2 to the newer Fraxel erbium:glass and Fraxel re:pair, I can state emphatically that acne scars such as you are describing don't usually respond in any meaningful way to these lasers. That is why I turn down more patients than I accept when they come in for laser treatment of acne scars.
The bad news is that you have undergone 8 procedures and still haven't had improvement. The even worse news is that you are about to go back to the same individual who has misled you for a *ninth* procedure. Wise up and go get a second opinion, hopefully with someone who doesn't continually suggest the same procedure that isn't helping.
A couple of items to address: the accutane didn't cause your acne scars, in fact it probably kept you from getting more. Accutane is an incredible drug that typically improves acne scarring more than all laser treatments combined. In fact, it is the first thing I suggest for patients if they have severe acne and scarring.
Last point to address: Asian skin and lasers like the re:pair aren't a good match. It is quite possible that you will trade a bad situation for a worse situation, especially in someone who has little or no training with this type of laser. This is not a simple laser and certainly you don't want to be someone's experiment.
3
October 15, 2008
Keep hyperpigmentation in mind with Fraxel for Asian skin
I have done asian skin for acne scars with the Fraxel re:pair (See my photos). Hyperpigmentation can occur with asian skin but keep in mind, it is usually easily controlled if treated quickly and aggressively. It is usually not permanent. Preventative measures by applying hydroquinones before and after will minimize your chances of hyperpigmentation. Steve Weiner, MD Facial Plastic Surgeon Destin, Florida
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10/15/08
Thank you for the quick reply, Dr. Weiner.
I have looked through the photos and am actually quite surprised at the results that the re:pair can obtain.
This brings me to my second concern: What exactly happens after the treatment? I've seen some photos where the face of the patient is completely blood-covered and crusty, and others where the skin is just really really red and swollen. Also, my doctor says that the re:pair has a 1 week downtime, but from other reviews it seems like the downtime can be anywhere from 2 weeks to several weeks. Is there a "average" downtime? Or does it vary from patient to patient?
10/15/08
There is about 2 days of oozing and bloody crusts. After that, the skin is beefy red for anywhere from 5-7 days. Peeling begins day 4 or 5 and ends in about 2-3 days. Good wound care is essential for rapid recovery and healing. I bring in clients quite frequently to ensure proper care. If everything goes without a hitch, you have a bad sunburn color to your skin at day 7 with very mild swelling. Some people will be redder than others. Average downtime for me is about 7-9 days. Some are as little as 4-5 days, some 2 weeks. It also depends on your degree of comfort with your looks. Some people don't want to be seen with their face red and slightly swollen so it might take 2 - 2 1/2 weeks to be comfortable or more. There is no pain after about 1 hour or less from the procedure and during your healing phase.
10/16/08
Thank you so much for your helpful insight, Dr Weiner. I am currently looking to get a second opinion from Dr. Sachit Shah, who is within driving distance from where I am. I'm pretty sure he has a re:pair machine at his clinic. (I hope he replies! :-P)
If I do give the re:pair a shot, what paintkillers, nerveblocks, etc. should be administered prior to the treatment? Also, what do you tell your patients to do post-op? I have heard that vinegar washes need to be done every 3 hours around the clock (even at night when you're sleeping?), as well as thick layers of aquaphor, and prescribed medication to fight infection and ease swelling.
Will the results take as long as the re:store laser to become evident (I waited at least 3 months for some improvement to be seen)?
Sorry if it seems like I'm bombarding you with questions. My skin is my main concern right now so this is really vital to me. You're helping a ton and giving me some hope. Thank you again for all the insight you have provided so far.
10/16/08
Please ask your doctor about all that, every doc has there own style and would leave that to him/her.
10/18/08
does it make a difference in your hyperpigmentation if you start using hydroquinones 3 weeks after treatment ?
10/18/08
I start hydroquinones 1 month before treatment and then restart it 1 week after the treatment. There are some docs who only use it after treatment I am told.