How should I treat PIH after a fractional laser treatment 7 weeks ago? Will it go away? (Photo)

Question

Whats really worrying to me, is the appearance of the pigmentation: on the one side of my face spots, on the other side heavy stripes. Is this normal? My dermatologist prescribed me a cream with hydroquinone, but told me to only use it twice a week. It's been 2 weeks now, I don't notice any difference. When will it start working? Is this the right treatment? We are taking a sunny holiday in 7 weeks. Is there any chance that this will dissapear by then? Thank you for answering!

Timothy R. Miller, MD · Answer

PIH, which is post-inflammatory hyperpigmentation is typically a temporary issue that subsides over time, sometimes in months, however.  Typical treatments include sun avoidance, sunscreens, and medications such as hydroquinone.  Your treatnng surgeon will instruct you on the best measures for you.I hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Dark scars can be problematic as they can be visible far longer than one might expect. The fundamental problem with dark scars is a process known as post-inflammatory hyperpigmentation in which the pigment cells near the scar are stimulated. In clinical practice, we always begin with application of Melarase AM and Melarase PM creams (coupled with Melapads) to help smooth out the color and pigmentation. Once the creams are started, lasers can be used to further reduce the scarring. 
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Erik Suh, MD · Answer

PIH is caused by overproduction of melanin due to heat and inflammation from laser treatment.   These clumps of melanin will eventually go away.  Hydroquinone can speed up the process by slowing down the melanin production in your skin, however, it does not make the melanin that has been already produced from the laser treatment go away. One way to breakup the melanin that already exist is q-switch laser.   It is an acoustic laser treatment which will breakup the pigment into smaller fragments, which allows your own immune system called macrophages to swallow the pigment and take it away from your skin.   Currently, the pigments are too big for the macrophages  to remove them from your skin.    It does not heat up the skin as much as other traditional lasers.   The same laser is used to remove tattoos from the skin, FYI.

Robert G. Aycock, MD, FACS · Answer

PIH happens even when patients are careful about avoiding the sun. It happens and can be treatable with  hydroquinone. Be sure to protect your face with a physical sunblock at all times and even a wide brimmed hat if you are outside. It will take time but will eventually go away.

David Rosenstein, MD · Answer

hisorry for the problemspih happensit can get better!!!but you have to be very careful with your skinhydroquinone is a good remedyNO SUN while your using itby itself, it can cause pihyou should never be outdoors without a physical sunblock that contains zinc AND titaniumi have my patients increase the frequency of use as their skin gets used to the creamno time frame unfortunatelybut if you irritate the skin during your recovery it will likely get worsebe careful and good luck

How should I treat PIH after a fractional laser treatment 7 weeks ago? Will it go away? (Photo)

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How should I treat PIH after a fractional laser treatment 7 weeks ago? Will it go away? (Photo)

Answers (5)

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Everything you need to know about Fractional Laser

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