A retrospective chart review to assess the safety of nonablative fractional laser resurfacing in Fitzpatrick skin types IV to VI

J Drugs Dermatol. 2013 Apr;12(4):428-31.


Background: Laser resurfacing in patients with Fitzpatrick skin phototypes (SPT) IV to VI is associated with a higher risk of pigmentary alteration. There is a paucity of studies evaluating optimum treatment parameters for fractional lasers in darkly pigmented skin types.

Methods: This is a retrospective review of medical records for patients with SPT IV to VI who were treated with a 1,550 nm erbium-doped fractional nonablative laser (Fraxel Re:Store SR 1550; Solta Medical, Hayword, CA). Data were collected from patient charts and the clinic laser logbook from January 2008 to January 2012. The frequency of treatment-associated postinflammatory hyperpigmentation (PIH) and treatment settings used were evaluated.

Results: A total of 115 total laser sessions (45 patients) were included in our analysis. Five of the sessions (4%) were accompanied by PIH, 2 of which occurred in a single patient. Only 1 episode of PIH lasted longer than 1 month (2 months). Two of the 5 cases had only transient PIH (≤7 days), one of which was reported by the patient and not clinically evident on examination.

Conclusion: The 1,550 nm erbium-doped fractional laser is well tolerated in SPT IV to VI. Fractional laser resurfacing, with the settings used and pretreatment and posttreatment hydroquinone 4% cream, was associated with a low risk of PIH in darker skin types.

MeSH terms

  • Cosmetic Techniques / adverse effects*
  • Erbium
  • Humans
  • Hydroquinones / administration & dosage
  • Hyperpigmentation / epidemiology
  • Hyperpigmentation / etiology
  • Laser Therapy / adverse effects
  • Laser Therapy / methods*
  • Lasers, Solid-State / adverse effects
  • Lasers, Solid-State / therapeutic use*
  • Retrospective Studies
  • Skin / metabolism
  • Skin Pigmentation*


  • Hydroquinones
  • Erbium
  • hydroquinone