I had a IPL treatment over a week ago. Prior to this treatment, I had a treatment in April which was fine. I had mentioned to my Dr. that I had recently been in the sun. She said that it looked like I was getting the beginning stages of Melasma and we should be aggressive with the treatment and do IPL on my entire face so I trusted her treatment plan. I went for a follow up to this recent treatment because I now have on both cheeks a pattern which is much like a stripe effect on one cheek and a coffee spill on the other cheeks. I had no sign of discoloration in the areas that are now damaged. She told me to wait two weeks and come back and that she will treat again. I can't really cover this damage with makeup and I look like a scary creature. I am becoming increasingly worried that I will never have an even skin tone again. She assured me that there was no perm skin damage but I am not sure if I am being naive to believe her. Please help me.
IPL Side Effects from Melasma Treatment
Doctor Answers (10)
You will get better if you stay out of the sun.
It sounds like this patient is prone to hyperpigmentation which is aggravated by the sun. With proper care it will improve.
The problem is a complicated one. Melasma (also known as pregnancy mask) is a very common and difficult condition to deal with. It appears in some women with hormonal changes, in others with chronic sun damage. It frequently makes its debut during the second or third decades of life. Because it is a disorder of increased pigment it is almost always made worse by the tanning effects of the sun.
Surprisingly, there is still a great deal of controversy in the medical literature about the basic pathology and pathophysiology of Melasma.
The corner stone of treatment is sun avoidance. In some patients Melasma is made better by conservative IPL, and in some patients it is made worse by IPL. This patient seems to fall into the latter category which makes further IPL risky - especially an aggressive treatment in the presence of a tan. One week is not a long time in the healing process, and although it is very disturbing to the patient, it should improve with time and sun avoidance. It may never go away completely, but it will become more manageable.
If it does not improve, it may be treated with a melanin inhibiting agent like hydroquinone or kojic acid.
When the pigment has retreated a decision can be made about further CONSERVATIVE IPL.
IPL is your worst choice for melasma
You have two different issues going on. The striping on one cheek sounds different from the coffee stain on the other. The striping sounds like hyperpigmentation (brown discoloration caused by the trauma of the treatment) and the coffee stain sounds like your Melasma is showing up more clearly.
The IPL will only make your Melasma worse. We are not sure why your practitioner used an IPL for the treatment as it is not FDA approved and most if not all light based devices will make Melasma worse.
The striping you see is caused by a treatment where the energy level is too high. When this happens, the heat of the device focuses at the surface of the skin rather than lower levels, causing blisters or burns.
DO NOT have another IPL treatment from this practitioner as they do not know what they are doing! Find an experienced practitioner that can help you solve the problems that you now have. Hydroquinone bleaching creams are a good option for both problems. And do everything you can to avoid the sun as this will delay the healing process and worsen your Melasma.
Stop IPL and Bleach your skin for quicker improvement.
The sun and IPL may contribute to hyperpigmentation with patient with a history of melasma. At this point, it is best to stop IPL's and get the pigment producing cells in your skin to calm down. This is best done by 'putting them to sleep', a bleaching cream may achieve this for you. Unfortunately, all of these types of creams will take much longer to work and the onset of the pigment marks.
You should probably return to your doctor and get a prescription for a bleaching cream like Hydroquinone.
Good luck and be patient. Apply the cream as directed.
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Prescription bleaching creams would be appropriate now.
the hyperpigmentation after your procedure could be due to a few things. Regardless, it is probably not permanent and you should have treatment to hurry up the recovery. usually a bleaching cream combined with retin A and a cortisone cream resolves these tempory problems quite well. i like to do a few very light chemical peels to speed up the results as well. don't worry, these things happen to the best of us and are treatable
Treatment of Melasma with IPL, topical treatments: Reduction in Pigment on Face
Hyperpigmentation of the facial skin requires the skills of an experienced skin expert. Melasma cannot be cured, but can only be treated. It is an ongoing process that will improve with laser, chemical peels, IPL, and topical creams.
Ironically, all of the treatments, excluding topical creams, can actually worsen the hyperpigmentation that they were meant to correct. Conservative treatment is mandatory.
Melasma and hyperpigmentation can occur from the following four factors:
- Sun Exposure
If you experience hyperpigmentation following any given procedure, contact your physician in order to start topical treatments as soon as possible.
IPL not a good choice for melasma
If indeed you have melasma, IPL is not a recommended treatment option. Although it may take longer to see improvement, topical creams such as hydroquinone can be effective in lightening the areas.
How are you doing 6 months after IPL?
I hope you're doing better now. Protecting your skin from the sun continues to be very important for you, especially as we're heading into spring.
Since melasma is a chronic problem, follow-up with a board-certified dermatologist can be critical for obtaining long-term good results. What you use on your skin can make a big difference.
Fraxel works better than IPL for melasma
IPL can leave discoloration and is not very effective on treating melasma.Darker skin people are not good candidates for IPL and often two weeks is not enough time for the tan to fades.Melasma can succesfully be treated mith Fraxel restore laser and pretreating the skin with hydroquinone, or bleaching cream improves the results.IPL seems to be working better for sundamaged skin or broken blood vessels on the face.
IPL is not a great melasma treatment.
It is true that sun exposure can cause an unwanted response to IPL. The melanin is a chromophore for IPL meaning that it is a colored target that absorbs the light energy produced by the intense pulsed light. Too much chromophore and the skin can actually break down.
The tiger stripping is due to the actual shape of the ILP crystal. The bad news is that a "no-down time" treatment suddenly has a lot of down time. However, these will often heal completely on their own. Certainly avoid more photofacial at this particular office. Time will usually heal the stripping and one week is extremely early.
Also, be weary of treatments that claim to improve melasma. Bleaching products also tend to produce little improvement. On the other hand, if your melasma got more obvious with sun tanning, consider avoiding sun exposure, or use appropriate sun screen. This may help fade the melasma.
The IPL treatment may be aggravating the melasma. Sometimes, hydroquinone and retin A formulations can improve the melasma.
Steven Wallach, MD
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.