Hypopigmentation scar from laser - how can this be treated? (Photos)

Question

I am just two years shy of the co2 laser treatment that left me with hypopigmentation and texture changes. A small incision scar is now a much bigger blemish. What are my options? I’ve tried dermaroller, micro needling, growth factor serum, silicone sheets, you name it, I’ve tried it.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Erik Peterson, MD · Answer

Hi there!Dr Peterson here. Thanks for sharing your experience. You’re not alone in the frustration that comes from experiencing hypopigmentation after a procedure. Post-procedure hypopigmentation and texture changes, especially after aggressive treatments like a CO₂ laser, can be very challenging to treat, and results often take patience and careful management.
Here’s what can help:
1. Sun protection: Daily broad-spectrum sunscreen is essential to prevent worsening pigmentation and help any treatments work optimally.
2. Microneedling with adjuncts: Microneedling combined with bimatoprost can sometimes help repigment areas by stimulating melanocytes in hypopigmented skin.
3. Topical treatments: • Calcineurin inhibitors or mild retinoids in select cases may support repigmentation. • Growth factor serums can support texture improvement, though pigmentation results are limited.
4. Lasers and light-based therapy: Non-ablative fractional lasers or low-fluence Q-switched lasers may improve texture but need to be approached cautiously to avoid worsening hypopigmentation.
5. Camouflage and cosmetic strategies: While working on repigmentation, tinted sunscreens are a great tool to help manage visual impact. Dermablend makes a really great, very high coverage makeup that I often recommend for patients with vitiligo or other pigmentation disorders. It’s pigmented enough to cover tattoos, so it can be a great option while you’re working on other strategies to bring the pigment back. 
Hang in there! It’s a long journey but there’s light at the end :) 
Because this is a highly nuanced and delicate area, it’s best managed by a board-certified dermatologist experienced in post-laser complications. With a carefully tailored plan, improvement is possible, though it may require multiple modalities over time.

Viva Eve Dermatology - New York · Answer

There's a variety of treatments that can be done to improve the appearance of the hypopigmentation and texture. Microneedling with Latisse and PDGF combines collagen induction with targeted pigment stimulation to improve texture, tone, and repigmentation in areas of scarring or hypopigmentation. The treatment enhances skin renewal while encouraging melanocyte activity for a smoother, more even complexion.

Hypopigmentation scar from laser - how can this be treated? (Photos)

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