Is PIH Following Fraxel Repair Permanent?

While it is possible that PIH can be permanent, it usually resolves with treatment. I put all my patients on the Obagi system prior to and after treatment. This reduces the chances for PIH dramatically. It is still not too late to try this and it will rev up the results of the Retin A significantly. Most of the time the problem to watch for is actually post inflammatory hypopigmentation, the opposite of PIH. This can sometimes come after PIH, so it isn't a foregone conclusion that you... more

Occasionally, particular in darker skin people, PIH is possible after lasers. Usually it is easily controlled with Triluma. This should only be used for 4-6 weeks. It contains a 4% hydroquinone, Retin A, and a steroid. If having no success, your doctor can prescribe higher doses of hydroquinone. This is done from a compounding pharmacy. I have heard of doses of up to 12% but I don't have experience with that. Once resolved, with proper sun precautions and skincare, it shouldn't come... more

PIH after repair occurs most commonly in people with more pigmented skin. If 4% hydroquinone does not work you may try a combination treatment such as TriLuma which has HQ, Retin-A and a steroid. The combination works well to eliminate PIH.