Hyperpigmentation and ingrown hairs from laser? Advice (Photo)

Question

I'm a 20 year-old Indian girl with olive skin and thick hair. ha laser hair removal when I was 17(I had12sittings) and I noticed moderate hyperpigmentation around legs and underarms I stopped with laser sessions. I have many ingrown hairs on legs which are not in the form of inflamed raised bumps, but are like brown spots with hair trapped deeper under the skin it's impossible to squeeze the hair out. My hyperpigmentation has reduced, I apply Tretinoin(0.025%).

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and helpful photos.  So sorry you are experiencing this!   It appears to be post inflammatory hyperpigmentation that is still present even after all this time.  In addition to your tretinoin, maybe ask your dermatologist for hydroquinone and a mild topical steroid cream.  One combination cream we have here in the U.S. is Tri-Luma, which combines tretinoin, a steroid and the hydroquinone all in one cream.  It is a prescription product and you won't want to use it for too long, but you could give it a try.  Best of luck!

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