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Post-Inflammatory Hyperpigmentation Due to Photo Facial Treatments

I am now 40, 3/4 Asian & 1/4 Caucasian and my skin is probably a medium Type 3. In Oct 2008, I purchased/started a package of 6 photo facial treatments (they call it IPO? not IPL), 2 Microdermabrasion treatments, and 2 Alpha peel treatments at a spa owned by a doctor, hoping this time, hyperpigmentation on my face would start fading. I couldn't see any noticeable effects after 3 photo facial treatments & 2 microdermabrasion treatments. Then, at my 4th photo facial treatment, the technician went very aggressive to see optimal results (She told me after the 4th treatment).

I was also recommended for a peel a week after that, and I did. It's been 3 weeks after the 4th Photo Facial session, and now I'm pretty sure I have PIH by my eyes as well as on my cheeks. Although a very, very heavy concealer can camouflage them to some degree, I would want to hide and cry every single day. During the course of my treatments, I was using 2 levels of bleaching cream (containing 5% or 8% hydroquinone & tretinoin) every other day and stopped using it 4 days prior to the next photo facial treatment. In addition, I've been using either SPF 45 or 58 every single day.

I have 2 Photo Facial treatments left at this doctor's spa. Is it still possible for the Photo Facial treatments at this spa to improve my PIH, or should I discontinue right away? If I should discontinue, what would be the effective treatment options left for me, given I have already tried Photo Facial, TCA peel, hydroquinone/tretinoin and Microdermabrasion? I desperately need professional help/opinions.

Thank you so much in advance for sharing your knowledge and experience.

Asked 38 months ago by sunkiss in LA, CA
Sort 3 expert answers by:
+3

Hyperpgimentation or Melasma

First let's address the issue of whether you should continue with IPL treatments or not. The answer to that is NO. The safest treatment for hyperpigmentation caused by IPL is hydroquinone bleaching cream. Another available option is q-switched laser treatments. This type of laser treatment should only be undertaken by a practitioner with extensive experience treating PIH with this laser. Going too high on the fluence (energy) can cause more damage with this laser so extreme caution and... more
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+3

Post inflammatory hyperpigmentation is a difficult situation

I'm sure that what you are describing is PIH (post-inflammatory hyperpigmentation). First, an SPF of 45 or 58 is not what you need. You need a sun BLOCK, not a sun SCREEN. A block contains micronized zinc oxide and / or titanium dioxide and truly blocks the sun's rays. This needs to be worn daily from sun up to sun down. I can't stress the importance of sun protection more. Secondly, I have found that IPL or IPO (whatever that is) is inadequate in treating PIH. In the past, I have treated... more
Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
+2

Hyperpigmentation after IPL not uncommon for Asian skin

Hyperpigmentation after IPL, or photofacial treatment is not uncommonly seen among Asian-American skin. Therefore, IPL should not be used a first line therapy for pigmentary disorder and when used, the parameters should be much more conservative for Asian-American or Hispanic skin types.
William Ting, MD
Bay Area Dermatologic Surgeon
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