Q: I have just read a few artcles from Dr Eppley and I would value his opinion on my scars. I had fractional laser treatment for three scars on my right cheek. Afterwards, unfortunately, I developed an infection as my skin would not heal and there was bleeding underneath. I could not get the area to heal so I ended up contacting a specialist out of the country who diagnosed it s fungal. I was treated with antifungal medications and it healed within a few weeks. While it healed, it developed a lumpy shiny texture. I then underwent intense pulsed light therapy and topical steroids to help the skin recover. This did help. After a while I was recommended to have more fractional laser treatment for further improvement. Despite having good results so far, I thought I could get even better. Unfortunately the settings may have been too strong and things became ten times worse. My right cheek has every imaginable scar and the texture is horrible, just like a burn. I am now having PDL and smoothbeam for one year with very mimimal improvement and I more recently had a PDT treatment which I am not sure if it helped as I am still very red. I seem to have exhausted everything and am now without any hope of looking normal again. Do you have any suggestions.
A: While I have not seen what your cheek looks like, it would be fair to say that the numerous laser and light treatments have ended up making the skin area act more like a scar than normal skin. All of these therapies, laser or light, produce a thermal insult on the skin. And just like burn skin, it will be more sensitive to just about anything you do. Unless…you give the skin area an adequate time to recover without doing anything including topical steroids. An adequate time is at least a year with leaving it alone. While that will understandably seem like an eternity, particularly when it is on your face, it is the best thing to do if ever you are going to do any more therapy that might ultimately be effective. Sometimes patients keep searching for the next light or laser treatment that will be the ‘magic’, when the real magic in some scars is time. I think it time to sit back and let the area fully recover and then re-evaluate.
Dr. Barry Eppley