Laser Spot Removal: Risks, Results, and Aftercare

Laser Spot Removal

Hello, doctor.
I previously went to a regional hospital for laser spot removal.
The procedure involved treating each spot with a single pulse, which felt like being flicked with a rubber band.
After the treatment, the spots temporarily enlarged and then formed scabs that fell off after about three days.
However, when I went to a clinic for laser treatment this time, the experience was very different.
They treated each spot repeatedly, like a machine gun, and the spots completely disappeared but left behind indentations.
They prescribed me a topical ointment called Bactroban Gel 1% (Clindamycin), which is indicated for acne vulgaris.
I have two questions: 1.
Did I encounter a disreputable clinic, or why was the experience so different? 2.
Is it appropriate to apply this ointment on the indentations caused by the laser? Will this lead to any long-term side effects?

johnny, 20~29 year old female. Ask Date: 2009/01/31

Dr. Huang Ruiyun reply Dermatology

There are many types of lasers, each with different indications, as well as some overlapping similarities.
It is crucial to have an accurate diagnosis, select the appropriate device, and perform the procedure correctly.
If your spots are superficial, there are quite a few options available.
Based on your description, the first treatment you received may have involved a ruby laser, an alexandrite laser, or a Q-switched laser.
The second treatment might have been with an erbium laser or a carbon dioxide laser.
After laser treatment, doctors often prescribe antibiotic ointments to protect the wound and prevent infection.
Personally, I frequently prescribe an antibiotic ointment containing tetracycline, but please don't misunderstand; it is not meant for the patient to apply to their eyes! Clindamycin is also an antibiotic that can theoretically be used, unless it causes itching or stinging, in which case it would be necessary to ask your doctor for a different ointment.
Wishing you a safe and smooth recovery.

Reply Date: 2009/01/31

More Info

When it comes to laser spot removal, understanding the risks, results, and aftercare is crucial for achieving the desired outcomes while minimizing complications. Based on your experience with different clinics, it seems you have encountered varying levels of treatment quality, which can indeed raise concerns about the professionalism of the facility.

1. Quality of Care: The significant difference in your experiences at different clinics could be attributed to several factors, including the technology used, the skill and experience of the practitioner, and the specific protocols followed. It's essential to ensure that any clinic you choose is reputable and staffed by qualified professionals. Look for reviews, ask for recommendations, and verify the credentials of the practitioners. If you feel that the treatment you received was subpar or caused harm, it may be worth discussing your concerns with the clinic or seeking a second opinion from another qualified dermatologist or cosmetic surgeon.

2. Post-Treatment Effects: After laser treatments, it is common for treated spots to initially appear larger or darker before they eventually scab and heal. However, the appearance of indentations or "dents" in the skin after treatment is concerning. This could indicate an adverse reaction to the laser, such as over-treatment or improper technique. The use of Clindamycin gel (the medication you mentioned) is typically aimed at preventing infection and managing inflammation, particularly if acne is a concern. However, it is not specifically designed to treat skin depressions or indentations caused by laser treatments.

3. Potential for Scarring: The development of indentations or scarring post-laser treatment can be a risk, especially if the laser settings were too aggressive or if the skin did not respond well to the treatment. It is essential to monitor the healing process closely. If the indentations do not improve over time or if you notice any signs of infection (such as increased redness, warmth, or discharge), you should consult a dermatologist immediately.

4. Aftercare: Proper aftercare is vital for minimizing complications and promoting healing. This typically includes keeping the treated area clean, avoiding sun exposure, and using recommended topical treatments. If your practitioner has prescribed a specific ointment, follow their instructions carefully. Additionally, avoid picking at scabs or applying makeup until the area has fully healed to prevent further irritation or infection.

5. Long-Term Considerations: If the indentations persist, there are treatments available that can help improve the appearance of the skin, such as fillers, microneedling, or laser resurfacing. Consulting with a dermatologist who specializes in laser treatments can provide you with options tailored to your specific situation.

In summary, while laser spot removal can be effective for treating pigmentation issues, the quality of care and the technique used are critical factors that can significantly affect outcomes. If you have concerns about the treatment you received, it is advisable to seek a second opinion and discuss your options for addressing any adverse effects. Always prioritize clinics with a solid reputation and experienced practitioners to ensure the best possible results.

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