I had IPL 1 week ago on my chest for hyperpigmentation. Should I be worried now about post treatment hypopigmention? Directly after the treatment I had erythema and blisters. I was told to ice and treat the area like a burn. I week later the area treated still has railroad track like lesions.
IPL Laser Hypopigmentation
Doctor Answers 8
Use ointments on IPL burns and give them time
Thanks for your question.
It appears like you obviously had an IPL burn due to high settings. While you are healing with crusting, make sure to put plenty of ointment on these areas and DO NOT pick off the scabs. The ointment (Vaseline, Neosporin, etc) will help you heal quickly, and the scabs will provide a natural wound dressing. Leaving the scabs on as long as possible will minimize scarring.
You will be left with a little discoloration for a while, either hyperpigmenation, hypopigmentation, or both. For hypopigmenation, there is really nothing you can do except to take good care of the healing as described above. Time will be the only thing to make these areas better. For the hyperpigmentation, if you get some, you can do a bleaching cream and with time, these areas will minimize.
Right now is the best time for your to minimize the bad effects. Take care of the healing and hopefully, with time, your side effects will appear minimal.
IPL Laser Hypopigmentation
This is a very unfortunate and avoidable complication. At this point, I would almost guarantee long term visibility of the rectangular areas. You should seek the help of an experienced dermatologist in improving this unfortunate outcome.
Hypopigmentation after IPL
Based on the picture you submitted, it looks like you have done a good job making sure that this injury heals well. Keep the area moist with neosporin and make sure to STAY OUT OF THE SUN. Do not pick or peel the scabs off, allow the skin to flake off naturally.
The area is pink underneath and will remain that way for a while while you heal. Based on the healing response so far, it does not appear that you will be hypopigmented from this trauma, but only time will tell for sure. Even if the area appears to be healed some time from now, try to stay out of the sun completely for at least 6 months. You should also check in periodically with your treating physician to monitor your progress.
Next time may we suggest Pulsed Dye Laser treatments for chest redness and q-switched Nd:Yg lasers for the brown pigment. The problem with IPL treatments for your condition is that the type of light energy used is not specific to either red or brown but is generic. That is why the incidence of side effects like this is higher with IPL treatments than with lasers.
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Pigment Changes Post IPL
IPL is a great treatment, but needs to be used with great caution on the chest. The chest picks up more sunlight browning and you have to be so cautious with any baseline tan color with IPL. Often we tell the patient that this is not the best choice of treatment for you and let’s choose another plan of treatment. The reason is because we don’t want to put patients in the place you are in now, which is how to treat these unwanted complications, such as the burns you have. A better choice in the beginning for you might have been Fraxel, and still might be considered once these have healed.
Allow the skin to heal
I am very sorry to hear that you had this result from an IPL. Unfortunately the skin on the chest tends to be thin, sensitive and darker in pigmentation requiring conservative settings.
Allow your skin to heal for at least 2-3 months with an occlusive ointment, no picking and diligent SPF use. Once the skin has settled with less "pink" it can be distinguished as hypopigmentation/hyperpigmentation. Hypopigmentation will not resolve completely. The area can soften over time but this can take months. The practitioner can use more conservative settings and go the other other way to minimize the demarcations. Pre-treatment with hydroquinone can be done to lighten the skin prior to these sessions and minimize adverse reactions.
The settings need to be turned down...
If you did not blister, and are not dark in skin color, the Hypopigmentation should be transient. It is easy to remove pigment from the chest, so lower settings are a good place to start. With the second treatment, the Hypopigmented lines will fade as more pigment is removed. If blisters or prolonged redness were present, the settings need to be turned down a bit.