Hyperpigmentation 7 Weeks After CO2 Laser Removal of Sebaceous Hyperplasia

Melarase AM and Melarase PM work well in our office to reduce pigmentation associated with aggressive laser treatments. Use the creams twice daily to acheive maximal response. Raffy Karamanoukian MD FACS

Thank you for your question! There is always the potential for hyper or hypo-pigmentation with any ablative laser. Hyper-pigmentation can last a long time but it’s almost always temporary. It is best to follow up with your surgeon at this phase of recovery as there are pluses and minuses with topical steroids, as you have been instructed. We wish you the best!

Thank you for your question. It is common to have hyperpigmentation or even hypopigmentation after an ablative laser. I always recommend to pretreat with a lightening cream such as hydroquinone 2 weeks prior to the procedure to reduce the risk of hypo/hyper pigmentation. follow up with your provider.

Hyperpigmentation is a common complication after fractional Co2 laser resurfacing. It is referred to as PIH or "Post inflammatory hyperpigmentation" and it can happen to any individual getting this treatment. Generally speaking, it will subside over time in my experience.Treatments for PIH that can be helpful are topical steorids, vitamin A derived skin care products (Tretinoin), and Hydroquinone. All these are included in a cream called Tri-Luma, which is my preferred topical for PIH.  One can prescribe these creams in various concentrations and formulations individually as well.Beyond topical agents and time, the other two treatments I have seen helpful are the use of pulse dye lasers and various types of Q-Switched lasers, the type that are used in tatoo removal. Here the physician experience and technology availability are very important.  

There is definitey hyperpigmentation following your procedure and proper care with products that are hydroquinone based and non-HQ based can help reduce this effect. I recommend Melarase AM and Melarase PM as well as protection from sun damage using Spectrase. Proper hydration and deep moisturization is also an essential component for the healing process (Elevase). Scler-X is a post inflammatory hyperpigmentation relief complex that I also recommend. 

Dear laser patient from Florida,

From your photo this appear to be inflammatory and usually will resolve with time as redness and inflammatory reactions are usually not permanent after this type of procedure.  You may want to inquire about an intense pulsed light treatment that may take the redness out.  Best of Luck

I like to use a high quality hydroquinone in follow-up after CO2 to prevent dyspigmentation.  I do appreciate the benefits of erbium lasers for cutting with less heat in treating things like sebaceous hyperplasia.  Still, when you want skin tightening Fractionated CO2 is the best we have.  I think you will get away fine with time and I don't believe high potency steroids will benefit the pigmentation at this point.  Adding a high quality hydroquinone such as EpiQuin micro or Lustra may be beneficial.  Good luck.

Topical lightening agents plus Retin A are useful for hyperpigmentation following laser resurfacing of the face.