Vanquish left a blister that burst and now I have a scar with hyperpigmentation about the size of a quarter. Help! (Photo)

Vanquish rarely can cause blisters like the one you experienced. Normally with time the scar will improve considerably but might take 6-18 months- A fractional lasler could help speed improvement of the scar- sometimes a bit of moisture will accumulate on the skin during treatment and that will cause localized heating and the blister

Hello there! Hot spots are normal to feel during Vanquish, but they should be addressed immediately. The provider should adjust the Vanquish paddles after having you rub the area with a massage stick. Typically use of the massage stick will bring blood flow to the area and decrease the sensation of heat, but adjustment of the paddles is also necessary if this does not resolve quickly. It appears that you experienced a burn during your treatment, and this is not normal.
Use of a topical lightener is advised following an experience like this. This will start to lighten the scar, but you will probably need other treatments to resolve this further.

Hi Chant82, Thank you for your question. Since the Vanquish treatment uses heat there is always a risk of skin irritation. Most technicians should check on you regularly and keep a fan pointed at the treatment area to keep sweat from building up and reduce discomfort "Hot spots". If it occurs again with future treatments I would reach out to the clinic where you had the service done to let them know so they can bring you in to evaluate and treat the area. As far as the pigmentation is concerned it looks like PIH or Post Inflammatory Hyperpigmentation, which usually lightens over a several months. To speed up the process a lightening cream such as Hydroquinone can be applied to the area.Best of Luck 

I am sorry for the burn you obviously had, and yes it can be from the heat of the machine. BTL lists that as one of the possibilities with treatments. Fortunately, we have not experienced that, as drying the skin is helpful as well as using a Zimmer chiller to spot treat hot spots allows higher energy levels and better elevation of temperature at the level of the fat cells. Time will make the scar better, and various lightening creams like hydroquinone,  vitamin C, Kojac Acid, many Tyrosinase inhibitors (Tyrosine is a precursor to melanin) like mulberry, blueberry, liquorice lighten the skin. Hydroquinone can have paradoxical darkening of the skin so vigilance is necessary. Fractional CO2 or Erbium can be helpful if the scar is not resolving adequately. Also regular massage of the scar can help to reorganize the fibroblasts as well. Marked pigmentary changes can be handled well by a Q switched laser, like the StarWalker by Fotona, has given us very good results in our office. I hope this was helpful, and that you get a great result.