Deep Hyperpigmentation from Folliculitis Scarring. What Treatment Would Be Best if Lightening Creams (4% Hydrqnone) Do Not Work?

I am an african american male affected by Folliculitis of the beard for several years and just recently I had laser hair removal (Gental Yag Laser) to get rid of the hairs. Although this has definitively helped with the underlying problem, after the hair was removed I had extensive hyperpigmentation from all the years with folliculitis. I was prescribed creams: hydroquinone 4% and and also Tri-luma, but for months, they have failed to lighten the area. Now considering peels. What would be best?

Doctor Answers 1

Hyperpigmentation from Ingrown Hair

Hi NG.  We have several suggestions.  Normally post-inflammatory hyperpigmentation such as you are describing will resolve on it's own if the ingrown hairs stop.  This is the normal progression over the course of a year with our laser hair removal patients.  So the first option is just to wait.

The second option is to find a physician's office where higher strength hydroquinone (HQ) is used.  At our office, we compound up to 8% HQ. 

Finally, we use q-switched ND:Yg lasers to address the issue when topical products like HQ fail.  Q-switched lasers are commonly used for tattoo removal, birthmark removal and sun damage, but can be very effective for removing long term dark scarring like you are describing.  Good luck.

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