What Can be Done For A Burning Feeling That Exists In Skin That Was Burned By Laser Hair Treatments?
Q: Dr. Eppley, I have an unusual question about a part of my face that was wounded by laser treatments. Several years ago I went to a family doctor in town that offered laser hair removal at a great discount. For that great fee reduction, I ended up getting several areas of burns on my face that have scarred. These have largely gotten better. My ongoing problem is on some facual skin areas that show no visible signs of scarring. Instead, there is an issue of a constant burning sensation under the skin. There is no scar and the skin looks normal but there is a constant burning sensation that occurs. So, my question for you is what could be causing this burning
sensation under my skin? It undoubtably occurred from the laser treatments since I did not have it before. What could the laser have damaged under the skin that caused this constant burning sensation? Most importantly, what can I do to fix it?
A: This is certainly an unusual problem. The laser may well have burned the ends of the tiny sensory nerves, which are more sensitive than the overlying skin to a thermal injury. This nerve scarring may have changed how those nerves feel due to the damage. That would explain why it feels like it is burning, years later, even though it is long past the possibility of any actual skin injury.
Time initially would be the first option. Nerves can heal and recover but that would, in theory, have done it by this point years later. If there has been no gradual improvement in that sensation lessening by now, then it may well be permanent. The next treatment option to consider is Botox. This simple injection approach will block the acetycholine transmission and the sensation may cease as long as the Botox is effective. (4 or more months) Whether it will work or not is speculative but that is exactly how it works in the treatment of hyperhidrosis for example. In addition there is nothing to lose as long as there are not muscles of facial expression nearby. If this is ineffective, then skin flap undermining in a minor surgical procedure will disrupt the nerve ends and may possibly end this dysesthesia.
Dr. Barry Eppley