Hyperpigmentation and Redness from Laser Skin Resurfacing

Question

I had laser skin resurfacing for acne in August, and I still have redness and hyperpigmentation. What is the best and quickest method to get rid of the hyperpigmentation?

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for the excellent question. Changes of pigmentation following laser resurfacing is a rare complication, but can certainly be very disturbing to the patient. Fortunately, the changes of skin color usually return to normal without any treatment. There is no "best" or "quick" method. If anything, time is often the best medicine. However, Topical Hydroquinone, Retin A and Steroids can be used, but caution must be taken with these products. Occasionally, they can worsen the irregular pigmentation. I hope you find this helpful. Good luck.

Raffy Karamanoukian, MD, FACS · Answer

Vbeam laser is an excellent modality for patients who have rosacea, blushing of the skin, facial and body telangiectasia, spider veins, redness, post surgical redness, and skin flushing. It is a safe procedure that can be used at varying depths to help treat micro blood vessels in the skin. We also use it in our office for facial skin inflammation, keloids, and hypertrophic scarring. It is an important part of scar therapy. Vbeam can be combined with chemical peels and other lasers, but experience with the treatment is essential. The Vbeam laser does not affect deeper tissue. Schedule a consultation with an expert in Vbeam and you will find it to be an excellent modality for many skin types. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Sonia Badreshia-Bansal, MD · Answer

There are no &ldquo;knockout&rdquo; quick fixes for Hyperpigmentation. The cause can be complex, and only moderation of the pigment, and preventing it from getting worse is all that can be done in some cases. Removal is a lofty goal, so it is important to be realistic. An ethnic skin specialist is where you should direct your questions for a laser and cream option. Some peels may be of benefit.

Sanusi Umar, MD · Answer

No need to worry. Experiencing redness and hyperpigmentation is normal after having a laser skin resurfacing procedure. In order to help the hyperpigmentation lessen, you can try using topical creams or hydroquinone; but these types of effects usually go away on its own.

Scott Trimas, MD · Answer

If your treatment is less than a month ago, then I would just wait for it to resolve. Sometimes resolution can be hastend by adding a topical retin a preparation once daily. Also, hydroquinone can help with transient hyperpigmentation and in conjunction with a low dose steroid can help it to resolve quicker. I would not start either of those regimens unless I was at least three weeks out from the resurfacing procedure.

Kris M. Reddy, MD, FACS · Answer

While hyperpigmentation usually goes away on its own, it can be aided with topical retin a and hydroquinone. Continue to communicate with the physician who performed the treatment so he/she can monitor and guide you appropriately.

D.J. Verret, MD · Answer

Redness after laser resurfacing can last for several months depending on the laser used. Hyperpigmentation can occur but usually resolves without treatment in about 6 months. To move things along, hydroquinone and topical steroids can be used to accelerate the healing process.

David Goldberg, MD · Answer

Generally, hyperpigmentation after laser resurfacing disappears within 6 months. If the hyperpigmentation has not disappeared within that time, I would advise you to see another physician for evaluation as to the cause of this. If the time since the laser resurfacing has been less than 6 months, the best way to treat this is with a combination of the best sunscreen and a bleaching agent. There are a variety of bleaching agents available including topical hydroquinone, azelaic acid, kojic acid, and a brand new, highly effective face depigmenting agent called Lumixyl. Lumixyl is generally delivered to the skin through the use of a specific kind of microdermabrasion known as the Silk Peel.

Brooke R. Seckel, MD, FACS (retired) · Answer

Redness is normal after laser resurfacing. Redness can last 3-6 weeks after CO2 laser resurfacing. After newer fractional erbium laser resurfacing, redness is usually gone after a week.
The fact that you have hyperpigmentation and redness suggests to me that you are probably out 3-6 weeks after laser resurfacing as hyperpigmentation takes 3-6 weeks to develop.
If redness and hyperpigmentation appear 3-6 weeks after laser resurfacing it indicates significant inflammation and personally I take action to reduce the inflammation.
I use a topical steroid such as 1% Hydrocortisone cream to reduce inflammation -but be sure to consult you treating doctor before doing this.
Once the redness is gone hyperpigmentation can be treated with Hydroquinone, a skin bleach and microdermabrasion. If these do not help, Retin A can be added after 6 weeks. If these theraqpies are ineffective, Photofacial or IPL-Intense Pulsed light-in the 550 to 650 nm range can be effective in reducing superficial pigment.
If you have redness and hyperpigmentation after laser resurfacing at 6 weeks and your doctor is taking no action I would see an expert Plastic Surgeon or dermatologist who is experienced in laser resurfacing for a second opinion.

Hyperpigmentation and Redness from Laser Skin Resurfacing

Answers (9)

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