What can I do to minimize the appearance of post inflammatory hyperpigmentation after Morpheus8? 4 months post op (photo)

Question

I had one Morpheus8 treatment on my stomach in the beginning of Nov 2022. Over 4 months post treatment, and my stomach is still red, with slightly raised bumps... I look "stamped." The provider called it post inflammatory hyperpigmentation and I've used retinoids, steroids, and a variety of natural oils and cream to get it to go away, with very little improvement. What else can I do and how long will it take?

Giuseppe Fiore, MD · Answer

Hello,
thanks for your question and photo.
I am sorry to hear about your experience. 
Post-inflammatory hyperpigmentation (PIH) is not very common complication after Morpheus8 treatment. PIH is characterized by the appearance of brown or dark spots on the skin that can last for several months, and can be especially concerning for individuals with darker skin tones.
In my opinion and experience , to minimize the appearance of PIH after Morpheus 8 treatment, there are several steps that you can take:

- Use a broad-spectrum sunscreen: The most important step in preventing PIH is to use a broad-spectrum sunscreen with an SPF of 30 or higher daily. Sunscreen helps protect the skin from UV damage, which can exacerbate PIH.

- Avoid direct sun exposure: It is recommended to avoid direct sun exposure, especially during peak sun hours (10 am to 4 pm), and to wear protective clothing, such as a hat and long-sleeved shirt, when spending time outside.

- Use topical lightening agents: Topical lightening agents, such as hydroquinone, kojic acid, and azelaic acid, can help fade PIH. These agents work by inhibiting melanin production, the pigment that gives the skin its color.

- Consider chemical peels: Chemical peels can help exfoliate the skin and reduce the appearance of PIH. Alpha hydroxy acids (AHAs), such as glycolic acid, and beta hydroxy acids (BHAs), such as salicylic acid, are common ingredients in chemical peels and can help improve skin texture and tone.
Consult with your doctor: If PIH persists or is severe, it is important to consult with your doctor. They may recommend additional treatments, such as laser therapy (e.g. Nd:YAG , Q-switched laser) or IPL  :  to help fade PIH and improve overall skin appearance.
it is important to understand that PIH can take several months to fade and patients should be patient and consistent with their treatment regimen. It is important to remember that the skin takes time to heal and regenerate, and results may not be immediately apparent. Patients should continue to follow their doctor's recommendations and maintain a healthy skin care regimen to optimize the healing process and reduce the appearance of PIH over time.
Hope this helps,
Dr Giuseppe Fiore

Danielle Shanley, MD · Answer

Thank you for your question. I would do a series of Diamond Glow treatments with the even and correct solution. I would also get on Skin Medica's even and correct system.

J. Jason Wendel, MD, FACS · Answer

Post Inflammatory Inflammation is typically more of a brownish color as opposed to pink  and raised.  You could be experiencing some persistent inflammation.   If this is what you are dealing with you will likely need a steroid cream to and sometimes a product with growth factors in it.  These two things together can help tremendously bring down the pinkness and inflammation.

Laura A. Katz, MD · Answer

First, thank you for including a picture.  it is very helpful.  This is more a matter of scarring rather than hyperpigmentation.  This is usually an indicator that settings or depth was too high for the treatment.  It can also be a matter of intensification of the treatment due to a lotion or self tanner on the skin.  If neither of these is the case, sometimes prolonged scarring will occur and it can take up to 6 months or a year to resolve.  Unfortunately you just have to wait it out.  You don't want to provoke further skin damage by trying to make it go away.  The body just has to do it on its own

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