Healing after Fraxel or other lighter lasers

Hello Dr. Irwin, I recently had a Clear and Brilliant laser done (on Friday). As I was told this is great in helping with pigmentation and/or melasma, which is my main concern with my face. I am now noticing, on day 4 that areas of my face that had pigmentation look brown and speckled and dry. Which actually kind of makes it look like it gave me melasma. Are these brown speckled looking areas going to slough off or is this here to stay? I am mortified: (I know that exfoliation is not recommended for the first week). Is an exfoliation recommended a week after? If so, what is the best way to exfoliate without causing irritation to my skin? Are there any brands of product you can recommend? I started using SkinCeuticals mild cleanser along with the lightweight pore minimizing daily moisture, and have been using that morning and night. I also have the Equalizing Toner, Discoloration Defense Serum, Advanced Skin Discoloration Corrector and also samples of the Reservatrol B E, C E Ferulic, Blemish and Age Defense, but have not used any of those yet. Am I able to start using any of these products or do I wait a week? Also any deeper explanation on the use of these products and samples I do have would be greatly appreciated. I am single mom of 3 boys and am headed to Vegas to lately celebrate my 40th and I just really want to look my best but most importantly feel my best! As this melasma has destroyed my self esteem and confidence for 4 years now and I just really want this gone :’(. Thank you your time and I appreciate any and all advice/help you can give. Sincerely, Nelly Torres Oh and to note that I am also using Elta MD Sunscreen UV Physical SPF 41

Again… you all ask the best questions! First, your clinic should have given you both expectations and written instructions for your skincare for the first 2-4 weeks after your laser treatment. Did they? If not, please contact them. But, generally here are some ideas. I’ll answer the above in reverse order.

Too many skincare products?

If you go to Vegas (Happy 40th!), I’m excited for you, BUT no sun on your face or the melasma will get worse again!! Take a big brimmed hat. There’s no true cure for melasma, just good control.

  • After any laser or peel, you want to think bland and minimal products for 1-4 weeks. Your doctor should specify.
  • You must use a high zinc sunscreen (15-20%) for at least a month afterwards. Here’s a tinted one too. And forever is better with melasma!
  • Start with a good moisturizer, a gentle plant based lightening cream, or a prescription hydroquinone, and a great sunscreen (see above)!
  • After those, you can add a new product in – one at a time – and one week apart. That way, if you get irritated or have a reaction, you’ll know which one it is.
  • Talk to whoever gave you all those samples about which ones to add first. Your skincare should be customized for YOU, not just a bunch of samples thrown at you.

It’s so great that you’re moving forward on this in a positive direction!  🙂

What to expect after a Fraxel, Fraxel Lite or Clear & Brilliant laser treatment:

  • All these are by the same company. Fraxel Lite is done with the Fraxel but at about 1/2 the energy settings. Clear & Brilliant is essentially the same under a different marketing name.
  • Yes – most brown spots get “speckled” and a little darker temporarily. Those will resolve generally in 3-7 days.
  • Your texture will feel rough and sandpapery for about 4-8 days.
  • Let’s just go low tech on the exfoliation. Usually it’s fine, after 1 week, to use a washcloth once a day to gently get the dead cells to slough with a non-drying cleanser.
  • You must use a high zinc sunscreen (15-20%) for at least a month afterwards. And forever is better!
  • More moisturizer is generally need for a month.
Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
Follow my skin tips and travels on Instagram!

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