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PIH Post-Active FX

asked 1 year ago by selfimposedhermit in capistrano beach, ca
Latest answer by William Ting, MD
Question viewed 560 times
Tags: cheeks, PIH

8-9 weeks post active fx, with no pre-treatment, have developed PIH on both cheeks. I am light skinned, a touch of olive. Compounded 8% hydroquinone/tretinoin is way too irritating for my skin. Someone suggested IPL, but I am just not sure. Also heard it can take 3-6 months to resolve. I have hydroquinone 4% which does not irritate, but does not seem to be doing anything, either. I think my skin is very sensitive. Does any doctor have any hope to offer? THANK-YOU!

5 answers to PIH Post-Active FX

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Post treatment pigmentation after laser resurfacing

While pretreatment for ethnic skin prior to fractional co2 laser resurfacing can minimize post-treatment pigmentation, there is no guarantee. When post-treatment pigmentation does happen, combination of hydroquinone, prescription strength topical retinoid, sun protection should be part of the therapy. Superficial chemical peels, microdermabrasion, and Q-switched Nd:Yag laser can be quite helpful. IPL should be avoided for post-inflammatory hyperpigmentation as it can make... more
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Post-Inflammatory Hyperpigmentation after Active Fx

In my experience with Active FX, hyperpigmentation is rare, but always a possibility. It is typically more frequent with the Deep FX component or with an aggressive Active FX. The good news is that post-inflammatory hyperpigmentation is reversible over time. It can take between 3-6 months and can be easily concealed in the meantime with makeup. Hydroquinone 4% is effective in speeding the recovery time. I often recommend a combination of hydroquinone 4%, retinol, and a mild steroid... more
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Hyperpigmentation after Laser

While pre-treatment can help lower the incidence of post-inflammatory hyperpigmentation, there is always a small chance of this developing. The good news is it  should resolve with time, and you can speed it up with some good skin care. 4-6% hydroquinone should suffice and physicians may also prescribe topical retinol 0.025-0.1% which may help by allowing the hydorquinone to penetrate and also by increasing cell turnover in the skin.
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Pigmentation after laser treatment: will it go away

Given the color of your skin this is always a possibility. In my hands, it is as high as 20% in selected patients. The good news is it does go away! It may take 3-6 months. We use a combination of similiar topical medications, light peels and IPL ( when it becomes more superficial).
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Peels can help PIH after Active Fx laser resurfacing

The touch of olive in your skin type plus possibly a little sun may have predisposed you to pigmentation after laser resurfacing (Active Fx, Fraxel or others).  The best treatment I have found is a combination of retinol plus 4% hydroquinone (brand name TriLuma is a prescription that fulfills this criteria), sunscreen daily, at least 30SPF (plus active sun avoidance) and light peels such as glycolic acid done at 3 to 6 week intervals.  Of course, in almost all cases the pigment... more

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