Doctor's Answers (5)
Although most patient's redness resolves 1-2 weeks after Fractional CO2 laser, it is not uncommon for the face to continue to be red or flushed up to a month after Fractional CO2 treatment. I note that subcision was also done and PRP was used. As such, redness may persist for a longer time.
After laser treatment, to facilitate recovery, it is recommended to wash the treated area with water regularly, avoid excessive sun exposure, and apply sunscreen.
It would be best to speak to your doctor to discuss the timing of your second procedure.
An aggressive session of CO2 laser can indeed result in a few weeks of post-inflammatory erythema. I have not seen your "before" pictures and will not be able to comment on the cause of your red spots. I would advise you to go back to the doctor who treated you to discuss the current treatment options. You should be on post-treatment skincare regime to optimise healing.
Fractional CO2 is an ablative laser which is effective for acne scars but can be too aggressive for Asian skin leading to erythema and hyperpigmentation. If this indeed has happened to you, ask for other options for your acne scars. Fractional non-ablative lasers or microneedling RF options have a better safety profile.
PRP is still not approved in Singapore for skin and aesthetic use, hence most doctors here would have little experience with its protocols and its use.
Communicate with your doctor on the next step forward, all the best.
I agree with Dr Chua. In addition, to answer your question on whether you should post-pone the 2nd session. I personally wait for the redness to subside before performing subsequent ablative laser sessions. Redness might be a sign that your skin has not fully recovered yet.
It is best for you to contact your doctor/clinic for advice regarding the timing of the 2nd laser session.
HI would be inclined to agree with Dr Chua and Dr Boey. It is a bad idea to do more lasers while your skin is in its healing phase. Energy devices such as lasers can result in increased pigmentation, and for some patients, fractional lasers result in "sensitive" and raw looking appearance especially if the frequency and number of sessions are too close/many.
Post laser care - sunscreen and even products such as Calecim can be useful adjuncts aside from time.
Feel free to consult your primary doctor to discuss further!
From past experience, redness generally resolves within 1-2 weeks after a typical fractional CO2 scar resurfacing treatment for most patients, consistent with what Dr Terence Tan has observed.
Some degree of redness is expected as part of the skin healing response induced by laser skin resurfacing due to the rich vascularisation and immaturity of the thin, newly formed epidermis. Having said that, it can understandably be concerning for many.
The redness may be more prolonged where more aggressive treatment is administered (e.g. in deeper scars). Some patients, who are often fair-skinned, may also be more prone to more prolonged post-laser redness, as well as persistent post-acne redness. In most of these cases, the post-laser redness usually resolves within 4 - 5 weeks from past personal observation. However, there are reports where they take 90 days to disappear, as the new epidermis fully matures and normalises.
Vascular lasers may help more persistent post-laser erythema fade faster.
Besides adjusting the laser treatment settings to suit your skin and lifestyle better, there are several measures we can take to help reduce healing time after fractional resurfacing laser. For example, prompt skin cooling measures, use of professional skincare formulated to boost post-laser healing (e.g. Calecim Professional Serum), LED light therapy, using an appropriate moisturiser and sunscreen regularly, avoiding excess heat and sun exposure after treatment, avoiding picking of skin, etc.
For patients who are still very prone to acne breakouts, it would be worthwhile discussing with your doctor about managing potential post-laser resurfacing pimple breakouts, which can also cause more prolonged redness.
Also, check with your doctor about the suitability of your skincare after laser resurfacing if you are using your own products since the skin is more prone to irritation when it is broken. Contact dermatitis can prolong skin redness as well. It should be mentioned that "natural" or "botanical" products can also cause contact dermatitis, despite the gentle nature implied.
Finally, there are several treatment options for acne scarring to suit different skin conditions. So speak to your doctor to explore further.