Clinical Outcomes of fractional laser resurfacing in Patients with facial hyperpigmentation
DOI:
https://doi.org/10.5281/zenodo.22814379Keywords:
fractional laser resurfacing, facial hyperpigmentation, melasma, post-inflammatory hyperpigmentation, ablative laserAbstract
Background: Fractional laser resurfacing, delivered by ablative carbon dioxide/erbium:YAG systems and by non-ablative near-infrared platforms, has become a mainstay treatment for facial hyperpigmentation because microscopic thermal injury clears epidermal pigment while sparing tissue needed for rapid healing.
Objective: This review synthesizes clinical evidence on fractional laser outcomes in facial hyperpigmentation, comparing ablative and non-ablative platforms, wavelength-dependent efficacy, phototype-specific adverse events, and combination strategies.
Methods: We synthesized randomized trials, prospective cohorts, and split-face comparisons evaluating fractional resurfacing for post-inflammatory hyperpigmentation, melasma, and solar lentigines, with attention to outcome measures, energy parameters, and complication rates.
Findings: Non-ablative 1,927 nm and 1,550 nm platforms produce meaningful pigment clearance with low post-inflammatory hyperpigmentation in darker phototypes, while ablative fractional CO2 achieves greater single-session clearance at higher rebound risk in Fitzpatrick IV-VI skin; combination protocols with tranexamic acid, hydroquinone, or platelet-rich plasma outperform monotherapy.
Conclusions: Fractional resurfacing is effective when platform and fluence are matched to phototype, with non-ablative devices plus topical adjuncts offering the best benefit-to-risk profile in melanin-rich skin, while conservative ablative protocols suit select lighter-phototype patients.
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