Will PIH Come Back on the Same Areas Post-Fraxel Treatment?

Question

I have a fair complexion and I tan nicely. I have post-inflammatory hyperpigmentation (PIH) on some areas of my face as a result of Fraxel treatment. It seems to be slowly resolving with the help of 4% Hydroquinone; but I am concerned that it will be a recurring problem every summer regardless of stringent SPF use.

Ron Shelton, MD · Answer

You have a susceptibility for PIH, so Fraxel might have been one trigger, but other factors, including sun exposure, may cause the pigmentation to be more evident in the future. It is recommended to use sunscreen, regardless of history of PIH, when exposed to the sun. You’ll decrease your risk of skin cancer and appear younger than your friends who don’t protect themselves.

Michael A. Persky, MD · Answer

Hi JGS,
Post Inflammatory Hyperpigmentation (PIH) will usually fade over time. It is important to wear a physical sun block, hats, and avoid over exposure to the sun. If you are like me, you like being outdoors, but need to remember to reapply your sun block frequently especially during the summer.
Good luck and be well.
Dr. P

Martie Gidon, MD, FRCPC, FAAD · Answer

Postinflammatory hyperpigmentation is not the same as melasma.  Once it clears using hydroquinone and sun protection, it should not recur.  You should however always use sun protection.

D.J. Verret, MD · Answer

Though post inflammatory hyperpigmentation is a diagnosis specific to the treatment you had, it is possible that you will have increase pigment when you have sun exposure. Sunscreens will decrease the pigment irregularities you may encounter but remember to use at least an SPF 30 and reapply often for maximal effect.

Will PIH Come Back on the Same Areas Post-Fraxel Treatment?

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