Fast facts

Fraxel Laser


What it is: a fractionated laser treatment designed for resurfacing wrinkled, sun-damaged, scarred and aging skin


What it addresses:

There are three types of Fraxel laser treatments that address a  range of skin problems and skin types. Fraxel Re:fine is a mild, non-ablative aesthetic laser treatment performed in a series for discoloration, age spots, and general improvement to skin tone. Fraxel Re:store is deeper treatment which uses a fractionated erbium laser and provides non-ablative treatment with minimal downtime. Fraxel Re:pair is an ablative fractionated CO2 laser for the most intensive resurfacing and epidermal repair.


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Question

Fraxel Re:store for Type VI skin?

I'm considering Fraxel Re:store laser for severe acne scarring. I have Asian skin which is between Fitzpatrick Type V and VI. I've never seen Fraxel before/after photos on Type VI skin. I've had mild peels before (e.g. lactic acid peels 30% and 50%) on my face without hyperpigmentation. Is there a serious risk of hyperpigmentation for me with the Fraxel Laser? Will low laser settings be effective without causing any side effects?


Asked by: angelique_evita
California

Answers (5)

Sort by: Most recent | Most helpful
1
December 3, 2008

Yes, but proceed with a well-qualified physician

Ronald Shelton, MD
Ronald Shelton, MD
Board Certified
Dermatologist
Higher settings might increase your risk of developing hyperpigmentation. Fraxel, however, has worked very well on patients with your skin type. It is important to see a physician who has a great deal of experience treating Fitz VI skin with the Fraxel Re:store so that you can benefit from the proper pre-treatment and post-treatment regimens that have been time tested by that physician. Also, should you develop hyperpigmentation, that physician should be well versed in developing a treatment plan for you to decrease the pigmentation.
2
December 3, 2008

Yes, but carefully

I treat Asian skin types with Fraxel Restore after at least 2 weeks of hydroquinone 4% and religious sun avoidance.  If you are indeed a darker skin type VI, I would recommend a skin test prior to treatment after hydroquinone treatment.   Acne scarring requires the highest Fraxel settings, and thus you have a high risk for hyperpigmentation. 

 

Good Luck, but be safe

3
December 2, 2008

Fraxel is a safe option

Mary Lupo, MD
Mary Lupo, MD
Board Certified
Dermatologist
Answer by Mary Lupo, MD

In my experience, the key is the treatment level. If it is kept low (TL 4) is a good place to start, I have not seen post-inflammatory hyperpigmentation. The treatment level determines the density or percentage of coverage, which is more important than the energy level used when worrying about pigment. The energy levels used should be high to go deeper for acne scars. It is always a good idea to be pre- and post-treated with retinoids and hydroquinone, and of course, sun protection. It is also a good idea to do Re:store for darker skin types in the less sunny winter months. Clinique Medical now has an entire line that seems to improve results from this procedure as well. Ask your dermatologist about this and other pre-and post-treatment protocols to improve results and decrease complications.

4
December 2, 2008

Fraxel re:store for Acne Scars in Asian Skin

Michael A. Persky, MD
Michael A. Persky, MD
Board Certified
Facial Plastic Surgeon

Hi Angelique,

Type VI skin is always risky to treat. Type VI skin, the darkest skin possible, has been treated with Fraxel re:store.   I have treated scars without pigmentation problems.

Asian skin is usually type IV.  We do treat Asian skin with Fraxel re:store at low density, multiple treatments, separated by at least 3 to 4 weeks.  Pre-treatment with a bleaching agent is also preferred.  There is a low risk of hyperpigmentation in any patient.  Avoidance of sun exposure and use of a good physical sun block and protective clothing is recommended.

Good luck and be well.

Dr. P

 

5
December 2, 2008

most likely yes

William Groff, DO
William Groff, DO
Board Certified
Dermatologist

First, I am wondering if you really have type 6 skin. Asian patients generally fall in the type 3-4 range. Imagine the darkest skin you have ever seen in your life and that would probably be a six. I lived and practiced in Japan for 2 years and have published articles on Asian skin and the Fraxel restore. We treat this type of skin in our practice on a daily basis and have great photos of this. In our research, we found that Asian skin is more likely to hyperpigment with increased density (% of skin treated in one session) and is not related to the depth of treatment. This technology is the best and safest for your skin type. You will most likely need at least 4 treatments. If you hyperpigment, it could last weeks to months, but the improvement in your acne scars will be long lasting. Seek out board certified derm or plastics for your treatment and make sure the physician does the treatment. Take care, Dr. Groff

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