lulu : yes, am asian too. My first treatment was at 8/250. I did total 8 treatments and setting of my last treatment was 18. My doctor did warn me everytime about hyperpigmentation after we went over 12. So, she is really not to be blamed for it. I insisted and assured her that I will deal with it later. I do have previous experience of removing hyperpigmentation and am not too worried about it. What took me by surprise is, it seems a bit more stubborn than I expected and I didn't realize its full extent until I healed fully. My plan to deal with it is, try hydroquinone based bleach for sometime and superficial peels. If that doesn't work, then Obagi blue peel after sufficent time gap. I just want to caution other people having non-white skin that this might be a side effect at high settings.

Morningstar : Am asian Indian and have type III skin ( fair olive with goldenish yellow tones ). Triluma is working to some extent but not as fast as I would have liked. In the past, I could always get rid of the hyperpigmentation within 8 weeks. I see only 30% difference in 8 weeks. Maybe, it is related to the healing of the skin and as time passes, I might see more results. I would be really curious to know opinion of Dr. Fitzpatrick regarding settings for non white skin.

Regarding concealer, I found that Eucerin Redness relief ( it has a green tint ) gives nice uniform coverage especially when skin is reddish / dark brown. Sometimes, I use Derma Blend on top of it.

Hi Morning Star,

I am skin type IV, that is fairly brown being of indian descent. I would not be surprised if we are some of the first patients to be treated 30mj and above. Obviously there is a big difference in going 20mj and above, but is there a point of no return? Is the improvement linear with depth or exponential? I am curious as to people who are treated at 35 and their extent of results. Assuming an age group of between 25-30 I would say if 20 and above fetches about 40% after 6 treatments would 30 above fetch about 60% improvement assuming linear distrubution?

I.e. Assuming 10 to 15mj gives 15-20% improvement after 6 treatments

20 to 25mj gives 35-40% improvement after 6 treatments,

thus would 30 to 35mj then give 55-60% improvement?

I think this would not be to unrealistic, but then again these numbers are highly speculative. I use them as a rough guide based on results reported and studies conducted. Again I am trying to quantify improvement in numerical terms. In the end I am sure treatments at 30-35mj will give better results, but are they significantly more outstanding then the next best aggressive setting?

My reasoning is - go all out, if you skin can take 35, then push it. If your paying all that money and enduring all that down time, then it's best to aim for maximum scar revision, and 35 may be the way to go. That is the 'safest tested' highest setting one can push at, so might as well push the fraxel to the max. At least you'll know that you got the best results possible from fraxel.

Blaster

Blaster,

It seems Australia are taking Fraxel to the next level. Fraxel is still fairly new and I am just wondering if you're the first patients to go 30kj and above? I am making a copy of your treatment levels to my doctor and see what he thinks. Here in the U.S. the doctor's standards are still conservative with the exception of billybob in San Francisco. Blaster, what skin type are you? And did that help factor on the levels you are being treated at?

thanks,

morning star

Blaster,

Do you really want to go that high?

I think maybe you are forgetting that fraxel only treats 20 percent of the skin everytime. I think increasing the number of treatments would be more effective than increasing the power. after 5-6 treatments most people still only have 80 percent coverage.

I mean at about 20 MJ the penetration is 1 mm. Unless you have really severe scarring i don't think you'd have over 1 mm in scar tissue. the dermis itself is only 1 mm thick on the face.

I know fraxel is expensive but why put yourself at risk for MORE scarring? I think one medium power fraxel a month for 1-2 years would yield satisfying results for you without the risk and downtime.

JJ and Blaster: This is a good discussion. A couple months ago I thought the highest setting was 30 because my nurse showed me Protocol sheets provided by Reliant that had a max setting of 30. In fact, at my recent session I asked nurse to confirm that max is 40 on their machine, which she confirmed. Another thing we both learned is that dial has only quinquennial settings after 25. I had asked for 27, but we both learned that dial has setting for 25, 30, 35, and 40. that's why I stuck with 25 and had 2 spot passes at 30.

Coolbreeze confirmed with Relaint that 40 mjs corresponds to 900 microns of thermal injury depth. Because the light beem is a line, I believe the depth is probably linear function of mjs. Therefore, at 20 mjs, you would only be reaching 450 microns. There are other factors to consider, but my wild ass guess is that if you have a scar that is .5 mm in depth, you need to have a setting of at least 20.

I agree with Blaster's approach of getting the most bang for the buck by going high, with a couple caveats. First, you should start lower to see how you tolerate and respond. If you have shallow scarring, are female, or darker skin, these are indications for being more cautious. Lastly, I am 2 days out and look really bad. In some ways, that argues for fewer procedures at higher settings to get it over with. On the other hand, this procedure is not riskless.

I have not decided on a possilbe # 5. But, when I am fully healed, I will post detailed pre and post pctures.

Coolbreeze: As your mj settings increased did she keep density at 250, or did she reduce to 125? How many passes in you last session?

Best wishes to all from the redfaced chipmunk known as Billyboy

HMM. In the video link that was posted a few pages back the doctor says that at 10 MJ the depth is 500 microns (.5 mm) and the circumference is 100 microns (.1 mm).

jj: I did not check link, but there is a disconnect. I read the 900 microns max on Page 7 of a continuing Med Ed Program for Plastic Surgeons dated in 2005 that I downloaded from Reliant site early this year. It says: " Depending on energy used, dermal wounding takes place in precise columns with collagen denaturization depths of 300 to 900 microns."

So, I'm inclinded to believe that 900 is max as per Coolbreeze's phone call woth Reliant. However, it is very possilbe that it is not linear function because the light beem's energy encounters increasing resistance with deeper penetration; (i.e., if 40 mjs corresponds to 900, 20 mjs might correspond to say 550 microns).

Some other numbers for comment:

MTZ width: 31.84 microns

MTZ depth: 500 microns

MTZ circumference: 100 microns

stratum corneum: 20 microns deep

epidermis: 100 microns (including s.c.) deep

dermis: 1000 microns deep

pore diameter: 50 microns

hair diameter: 80-100 microns

wavelength of visible light: 1 micron.

smallest particle diameter visible with naked eye: ~30 microns

26 gauge needle diameter: 457 microns (used for "needling")

I don't know how a hair's diameter can be less than a pore, when hairs grow out of pores. But that's what all the science sites say are the diameters.?

I wonder how deep an MTZ can go if it lands directly over a pore? Either way it's nice to now that an MTZs diameter is less than the diameter of the average pore. But at 30 microns that would still make an MTZ visible. I guess you can't see them when you get a fraxel though cause the stratum corneum is left intact. You might only see it later if it left a scar or something.

The cost per Full face Fraxel varies greatly. I have a special with my doctor since my photo is used on her Before/after on the web site. I get it done for $500 which is a No Brainer to have it done. I dont think it is worth more then $1000 per treatment and lots of doctors charge even more. If you can get it done for around$700 per treatment and can handle the aggresive high laser settins it probably would be worth it and you should be able to find a doctor to do it at that lower cost.

Good luck

Check out my photos at www.laserskinsolutions.com go to procedures/Fraxel and down load before after I am the male on the right.

 

FYI

Several Years ago I had the Cool Touch laser done (also 4 full face treatments)

I was in my late 30's at the time.A I recieved no visable improvment to my acne scars. The level of improvements after 4 Fraxels was pretty substantial (maybe 30% to my worst scars ) I had a 5th 2 months ago and that boosted the improvements even more

Just had a touch up with a filler (restylane) and now I am at 75% improvement in my worst scars.A Fraxel Plus a filler has produced the results i wanted now I need to see how long it will last.A I will have more fraxels next year and maybe do some sculptra.A If I maintane 60% or more improvements 3 months from now I will consider this a success.A

u

 

they charge 2400 dollars for 4 treatments of fraxel (they dont do spot treatments) ...A i dunno why they dont go over 12 ... but he said id be happy with the results from cooltouch since im young (22) and my skin will heal good both for my ance and scars .... i wanted to say if im not happy can i kick u in the nuts lol but anyways i think i might give cooltouch a shot since im bout to move back home and 1000 dollars would be like paying 3 months rent that i wont be paying anymore lol ... if im not happy with that then ill look into getting fraxel done somewhere else that will go over 12 and do spot treatments only ... but i am looking forward to my face totally clearing up from acne which will probably make me look a lot better than i think even with my few scars..... my gf doesnt seem to care about my scars soo maybe she will think im a total hottie when im completely acne free lol.. im really hoping i respond well to the tetracycline i was worried about the cost since i dont have insurance but it was only 11 dollars lol .... anyways he wants to do the cooltouch 2 weeks apart and theres only one day down time in which i cant go out in the sun but ill prolly go ahead and have it done on friday mornings soo ill have friday saturay and sunday to heal and possibly monday if needed ........ well thanks lightgirl youve helped me soo much and its been comforting having someone to talk to

 

798333[/snapback]

 

 

798716[/snapback]

 

Well Done Mate thats what I love to hear,Am thinking about Fraxel myself aswell at some stage next year.Howmuch it cost?

 

798735[/snapback]

 

 

there's a 99% chance that i'll be getting 4 fraxel treatments this september.

by the way, in that before/after picture of you, how many treatments did ya do?

Hi,

Quite optimistic to expect 70% improvement. Depends on your scars (ice-pick scars are poor to respond), the number of treatments and the level used.

Generally the consensus from the board and from group studies is results ranging from 40-45% after 5-6 treatments at aggressive settings (>20mJ and 10+ passes per treatment).

I am skeptical of people getting more than 50% unless all their scars are shallow to being with. A realistic goal is to expect around 40% improvement at the end of the treatment. If you feel that this justifies the cost and down time then by all means go for it.

In my case I paid $1700 for 5 treatments in Melb, Aus and because of the aggressive treatment I am seeing results. So far 4 weeks after my 3rd treatment I have seen 15% improvement. The main benefit for me is that I have not gotten a single break out of cystic acne since I started treatment 3 months ago! Some how fraxel shrinks the sebacous glands and reduces oil production.

I agree with BillyBoy in the sense that each treatment only covers 17-20% of the skin so 5 treatments at least would be required. 8 treatments at high intensity would probably give good results I imagine. Something like -

Level x Density x Passes

1st - 20 x 125 x 6

2nd - 22 x 125 x 8

3rd - 25 x 125 x 8

4th - 26 x 125 x 10

5th - 26 x 125 x 12

6th - 28 x 125 x 12

7th - 30 x 125 x 12

8th - 30 x 125 x 14

Each treatment would be spaced 4-5 weeks apart. The last 2 treatments would need about 5-6 weeks spacing. Nobody has done 8 treatments at this level, but I reckon it could give 50%+ improvement. It would take close to a year though.

That would be an interesting case study. For most of us, 5 treatments and around 40% improvement is the norm.

Blaster.

 

 

Question 🙂 I know a lot of you have had the fraxel laser treatment and I was just curious about numbers. My dr said I cld have up to 70 percent improvement, but of course it is probably just talk... so I am looking for more realistic numbers. Thanks!

 

Very well could be. Depends on the settings, number of treatments and how your body responds to the treatment.

 

Hey, M-Mite,

I am going for my 4th Fraxel on Friday. How much % improvement have you seen so far, and how many treatments are you planning to have?

Blaster.

 

Hi guys just an update. I had my second fraxel at 20 and had 12 passes, last month. Just went in for my 3rd fraxel. This time it was aggressive again 14 passes at energy levels 25-30. Shall keep you posted on how im going.

love,

M

 

 

I think probably the best and safest option for me would be to increase the number of passes at 30 on my next treatment and throw in spot treatment at 35.

Essentially 4th treatment was 25x6x125+30x6x125

So for my 5th I'm thinking 25x6x125+30x8x125 with spot treatment at 35 for 2-3 passes.

I think the risk-benefit ratio of going to 35 doesn't justify that treatment. I have pretty much maximised the treatment level of fraxel so anything higher would be really pushing it.

I am going for 6 treatments, so 2 more to go. The downtime is a real pain, so I am looking forward to ending this soon. 5th treatment is next week. Will schedule 6th and final treatment 5-6 weeks after that one.

Each fraxel generally covers 12-20% of the skin. Assuming an average of 16%, then 16x6=96% which should cover my treatment quite well.

The cost and down-time of fraxel are too high, so I am not prepared to do this every month. After the 6th treatment I am done. Finished. I will take whatever my results are and be done with it. Time to get on with my life!

Blaster.

Blaster,

 

Do you really want to go that high?

 

I think maybe you are forgetting that fraxel only treats 20 percent of the skin everytime. I think increasing the number of treatments would be more effective than increasing the power. after 5-6 treatments most people still only have 80 percent coverage.

 

I mean at about 20 MJ the penetration is 1 mm. Unless you have really severe scarring i don't think you'd have over 1 mm in scar tissue. the dermis itself is only 1 mm thick on the face.

 

I know fraxel is expensive but why put yourself at risk for MORE scarring? I think one medium power fraxel a month for 1-2 years would yield satisfying results for you without the risk and downtime.

 

Blaster: Your plan makes perfect sense.

On the surface, it appears that your total energy was about 30% higher than mine on #4, which totaled 11.7KJ, so I am sure you are getting more bang for the buck. If you look 30% worse than I do, please do not approach young children.

I find I get the best benefit in areas that peel. For some reason, my nose and a few other areas don't peel.

Do you peel everywhere?

Hi,

Yup, I peel everywhere, nose, cheeks and forehead. I look pretty bad up to 4 days after treatment, so I normally schedule treatment for Friday afternoon, then take Mon and Tue off, so I return to work on Wed. It takes 4 weeks for the redness to go down and for me to look back to my normal self.

Blaster

Blaster: Your plan makes perfect sense.

 

On the surface, it appears that your total energy was about 30% higher than mine on #4, which totaled 11.7KJ, so I am sure you are getting more bang for the buck. If you look 30% worse than I do, please do not approach young children.

 

I find I get the best benefit in areas that peel. For some reason, my nose and a few other areas don't peel.

Do you peel everywhere?

 

Blaster, are you getting pin-point bleeding?

Anyone else? Im wondering if pin-point bleeding is a negative or means you are getting a good treatment?

Billyboy : My doctor used 250 density till 14. My last two treatments were 15/125 and 18/125 with 8 passes.

I get pin point under eyes at higher settings, where there is a lot of vascularity close to surface. My nurse tended to back off more passess when it started to bleed.

Can Fraxel be done on Dark Skinned individuals? Sorry if its been brought up already. Long thread lol

I only got pin-point bleeding on my nose tip. I don't attach any significance to pin-point bleeding. I don't think its a good thing though, could be a sign of over treatment.

We should have a Fraxel FAQ so people won't have to keep replying to the same questions over and over again.

Blaster.

Blaster, are you getting pin-point bleeding?

Anyone else? Im wondering if pin-point bleeding is a negative or means you are getting a good treatment?

 

Had my first fraxel 18 days ago, performed by Dr.Rapaport.

1st session: $1500 : 19mJ x 125density x 10passes

2nd session: $1500

3rd session: $1500

4th session: Free

5th session: $750

Average cost per treatment: $1050- (no consultation fees, before or after)

Severe scarring all over the face, he thinks its mainly box scars and not that deep but yet they are quite severe since they are all over the face overlapping eachother. I had posted pictures earlier on if anyone recalls them they would vouch that i probably have the worse scarring on this board. Asian, skin type probably IV. After the first fraxel swelling for three days, skin turned leathery. Peeled a lot, similar peeling as seen after a tca peel. I believe i ended up with hyperpigmentation, the doc did prescribe lustra which i am currently using to no avail. Some people reported a bronze skin tone, i dont think its bronze for me but quite dark i can clearly see the demarcation line. Skin feels smoother to touch but for some reason became more oily. Scars look pretty bad rite now probably cauz of hyperpigmentation (i hope), i am starting to get a bad feeling about this. Second session next thursday, thats when i will be seeing him again after my first session lets see what he has to say.

Question: What in your opinion would be the result if i were to do tca cross between my treatments? i-e when i heal from each fraxel i perform tca.

Had my first fraxel 18 days ago, performed by Dr.Rapaport.

1st session: $1500 : 19mJ x 125density x 10passes

2nd session: $1500

3rd session: $1500

4th session: Free

5th session: $750

Average cost per treatment: $1050- (no consultation fees, before or after)

Severe scarring all over the face, he thinks its mainly box scars and not that deep but yet they are quite severe since they are all over the face overlapping eachother. I had posted pictures earlier on if anyone recalls them they would vouch that i probably have the worse scarring on this board. Asian, skin type probably IV. After the first fraxel swelling for three days, skin turned leathery. Peeled a lot, similar peeling as seen after a tca peel. I believe i ended up with hyperpigmentation, the doc did prescribe lustra which i am currently using to no avail. Some people reported a bronze skin tone, i dont think its bronze for me but quite dark i can clearly see the demarcation line. Skin feels smoother to touch but for some reason became more oily. Scars look pretty bad rite now probably cauz of hyperpigmentation (i hope), i am starting to get a bad feeling about this. Second session next thursday, thats when i will be seeing him again after my first session lets see what he has to say.

Question: What in your opinion would be the result if i were to do tca cross between my treatments? i-e when i heal from each fraxel i perform tca.

 

Give it time, the first couple of treatments are genearly tough. You will start to see results after your second treatment. Be patient, you are in good hands. 🙂

I haven't posted in awhile, so I thought I'd give an update on my fraxel experience. I have had 5 treatments so far and have one more to go. My skin has not stopped breaking out since the treatment began. When I say I've been breaking out I'm not implying that I've just been getting little whiteheads-- I have been getting cysts, which I hadn't had since before I was on Accutane years ago. In fact, one of the cysts gave me a new scar. I have been put on two oral medications, neither of which have helped. The breaking out has been terrible, and for this reason alone I don't think I would consider doing fraxel again after this series. It's just very difficult to swallow the fact that for years I had perfectly clear skin, and now fraxel is making me feel like my pre-Accutane days. It seems there has been some scar improvement overall, but, in my opinion, it's too early to tell with absolute certainty. I'm going to wait until many months post-op to determine if my scars have truly decreased.

Sorry to hear about the cysts. I also had 5 Fraxel treatments and did have one cyst pop out of no where the third day after my 4th Treatment I actualy whent back to the doctor and had her Drain the cyst. it was half the size of a golf ball! thank god we got it early and it left only a slight mark which I dont even notice unless I try to look for it. As far as my skin I have had far fewer break outs this past year then I have had in years my skin feels smooth and pimple free. I do take monoxadil I take one pill each day for a week every other month and that seems to be a good Pre emptive strike against the bacteria deep in my skin I have had ZERO boils/cysts since I started that regimine. Its better to KILL the bacteria BEFORE you break out LOL. I have also been having Sculpta treatments to PLUMP up my cheeks and chin areas which were quite sunkin after many years of bad acne. I am happy to report that 3 weeks after my third Vial (it has been a 6 month process) I have seen pretty dramatic revolumizing of the areas treated and there has also been a further softening of the acne scars. Fraxel Plus sculptra may be the answer to Long term improvement to severe acne scarring!

I haven't posted in awhile, so I thought I'd give an update on my fraxel experience. I have had 5 treatments so far and have one more to go. My skin has not stopped breaking out since the treatment began. When I say I've been breaking out I'm not implying that I've just been getting little whiteheads-- I have been getting cysts, which I hadn't had since before I was on Accutane years ago. In fact, one of the cysts gave me a new scar. I have been put on two oral medications, neither of which have helped. The breaking out has been terrible, and for this reason alone I don't think I would consider doing fraxel again after this series. It's just very difficult to swallow the fact that for years I had perfectly clear skin, and now fraxel is making me feel like my pre-Accutane days. It seems there has been some scar improvement overall, but, in my opinion, it's too early to tell with absolute certainty. I'm going to wait until many months post-op to determine if my scars have truly decreased.

 

I haven't posted in awhile, so I thought I'd give an update on my fraxel experience. I have had 5 treatments so far and have one more to go. My skin has not stopped breaking out since the treatment began. When I say I've been breaking out I'm not implying that I've just been getting little whiteheads-- I have been getting cysts, which I hadn't had since before I was on Accutane years ago.

It's unpredictable how the Fraxel affects each person. I've heard of people not breaking out at all, but I'm not one of those either. It's like clockwork, 5 days after I've had a Fraxel, I break out in tiny whiteheads and red irritated 'rashy' areas. Fortunately, it clears up within a week and my skin looks much better. But I've been taking B5 for 2 months now and I wonder if I hadn't been using it, if I would be getting cysts. Fraxel is may only treat 20% of the skin at a time but it's still a lot of trauma to the face. I'm going to stick it out though...I have my 7th treatment next week and then intend to get an additional 3 right away. I just want to get it over with.

My thoughts on fraxel Aaaoe some constructive criticism

1.Fraxel results probably are temporary Aaaoe I think we will find out one would have to maintain results over time. Even if sunscreen is used, sun spots/photo damage skin will come back as well as wrinkles. Collagen is continuously remolding so scar treatment is more than likely temporary -TBD. Cost will probably adjust significantly from these findings. So once you think you are done with fraxel you are probably not done. I think once you complete for example 5 treatments your after picture will still be better than your before picture although the results will plateu and more than likely decline.

2.Fraxel will more than likely damage the vellus hair follicle especially at high settings. To what extent no one knows yet. I have come to this conclusion from my research and discussing this topic with several doctors I respect and believe. The vellus follicle is 1mm in length and is important for skin remolding.

3.Fraxel will most likely not damage the regular human follicle which is good news for men.

4.Fraxel can and does make scared pores worse. Sometimes it makes them better.

5.Fraxel can cause hypertrophic scars at very high settings as well as indents some times. Much of this depends on the experience of the laser operator and number of redundant passes especially in small areas.

6.Some people have had great results with the treatment others have not had any improvement.

7.Fraxel by itself is probably not the only modality for better results. Fraxel combined with subcision(both needle and saline injection) with a dermal filler would probably give the patient better results.

I am not trying to be a total downer on fraxel as I am still considering it to help with photo damaged skin and some shallow scarring. All I want to do especially for myself is to put some sort of sanity check on this relatively new laser. I do think the expense of the laser is much too costly right now.

It would be good to hear additional constructive/objective feedback pertaining to this laser. The good things and the not so good things. Some of you have published clinical trial data which is great!

Thanks for your input and experience. I did search for the follicle research item, but did not find it. I'll search again using your sn as a keyword.

 

The follicle question came about because I was researching different lasers and how they impact the hair follicle. Some experts agree with one another that lasers damage the hair follicles that produce the stem cells for needed for skin renewal. This would be bad if laser patients want to get incremental more improvement after the laser procedure with other procedures via c or copper, etc. They don't classify which lasers would cause damage so an assumption Fraxel doesn't, but I don't know.

 

I had the bulk heating happen on my nose with a diode laser. it left me hypopigmented. the tech turned the machine all the way up since it was less sensitive there. and foolishly overlapped.

 

I asked the hair follicle question months ago. It doesn't seem to affect them. Seems it would from the MTZ's cross-section on the reliant site. But the dermal papilla from which the hair generates is too deep and unless the capillaries that feed it become compromised it can usually regenerate.

 

Hells A: You are starting at a slgihtly hgiher total energy than I had in #2. That is good. Hopefully, you will not have to deal with hyper. You must be patient. I am still peeling from #4 and I won't know how I will grade this treatment for a couple more weeks.

I have never tried TCA cross. However, if I were to try this I would wait at least 3 weeks after Fraxel and then treat say 2 scars that look very similar to two other non treated scars. That way you can compare to see how the treated progress against the non treated.

Romulus: You raise some good points, but there is no doubt that my skin texture and tone has improved greatly. Pores are smaller and very shallow scars are gone. On the other hand, this may not be permanent and the results on deeper scars have been weak so far. I tried to fix deeper scars by going to Dr Y for floats, but they did not work very well. Unfortunately, if I had known about this, I could have used Coolbreeze's doc here in Bay Area for dermal grafts. But, I really think my skin is close enough to the point that I don't want to mess with it anymore.

Also, I think Fraxel is pretty safe. The reports of problems are rare compared to other procedures. Moreover, I think this fractional resurfacing makes so much sense from a pigment risk and healing perspective.

HellzAngel : I don't think it is a good idea to do TCA CROSS along with Fraxel. If you are going to be treated with high settings, you will not fully recover from the treatment for atleast 3 weeks. TCA CROSS involves using high % TCA and though localized, would need 3-4 weeks to fully heal. So, you would need to do Fraxel treatment every 2 months or so. Also, even though skin looks like healed 3 weeks after the treatment, it is just surface healing and depending on the depth, it is still healing from inside so you would not want to irritate it more using TCA.

Regarding hyperpigmentation.....I can related with what you are describing, having faced it myself.

I think, you have already signed up for 5 treatments. Otherwise, I would have definitely asked you to reconsider your approach.....first do as much scar revision as possible and then Fraxel. This is especially true for non white skin. That way, lower settings can be used for Fraxel and you would see less issues such as hyperpigmentation. In my opinion, Lustra is okay but 3-4 weeks to treat it in between the treatments is not enough. I would be curious to know what you doctor's opinion would be about this.

Although it can be disheartening ( instead of bright even tone, skin looks blotchy and that masks any improvement in the scars ), there are quite a few effective ways to treat hyperpigmentation and it is certainly less difficult than scars. Apart from bleaching creams, chemical peels rock : light and medium depth peels. They can improve color and tone 100 %. But that needs to be done after all Fraxel treatments are done and skin is completely healed. So, there is hope. One just needs lots of patience and perserverence to go thr' it.