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Hyperpigmentation from Co2 Laser, After 1 Month Not Fading. What Options Do I Have?

Doctor Answers (4)

Reducing discoloration and hyperpigmentation and PIH after fractional co2 laser

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All of my fractional CO2 laser patients use Melarase AM and Melarase PM starting three days to five days after the procedure to reduce the risk of hyperpigmentation.

Raffy Karamanoukain MD FACS
Los Angeles


Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Treatment Options for Post CO2 Laser Hyperpigmentation (Increased Darkening of Skin)

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The skin will often times respond to Laser Energy treatments with red or brown skin discoloration. First and Foremost you should get a second opinion from a Facial Plastic Surgeon or Dermatologist who performs similar treatments to confirm diagnosis and treatment options.

For redness protective barrier moisturizers, time, and topical steroids will help heal the skin. For brown discoloration treatment mirrors the above during the initial healing phase (usually first 2 to 3 weeks). At 4 weeks if the skin is less irritated looking, but still has a brownish discoloration, that was not present before the procedure, one may be dealing with PIH (post inflammatory hyperpigmentation) which will require on average 12 weeks of therapy using Retin-A, Hydroquinone, and a topical steroid (prescription item,  Triluma). These can be compounded or prescribed separately to customize the patient's treatment regimen. Obagi Nu Derm should also be considered for long term reduction in recurrence with Retin-A. 

Laser treatments for "stubborn" hyperpigmentation can include IPL or long pulsed 532nm laser treatments. This resistant hyperpigmentation also may require a series of treatments with these or similar wavelengths 4 to 6 weeks apart.

Michael B. Lyons, MD, FACS
Mobile Facial Plastic Surgeon
3.0 out of 5 stars 3 reviews

Hyperpigmentation after Laser Resurfacing

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 Hyperpigmentation is not uncommon, especially if you are of Hispanic or Mediterranean origin. I have never seen permanent pigmentation and I have been doing laser resurfacing since the 1990's. Still, it can be distressful. Use a strong sunscreen daily and reapply it every 2 hours. Also us a bleaching agent and consider intense pulsed light treatments.

William M. Ramsdell, MD
Austin Dermatologic Surgeon
5.0 out of 5 stars 1 review

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CO2 laser and hyperpigmentation

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You must stay out of the sun!  Wear sunscreen with SPF 50+, makeup and a hat.  Return to your doctor who can determine if a fading cream is necessary.  If the hyperpigmentation is still present after the summer, you may be a candidate for light chemical peels that can help with fading.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.