Is Hyperpigmentation Due to Chemical Peel Permanent?

Question

my mother had very good, clear skin. she had medium chemical face peel 2-2.5 years ago and she developed hyperpigmentation very soon after the procedure. Since then she has been using Obagi Creams, Sunblock and has been getting monthly laser treatments. but the pigmentation never fully vanishes and returns after exposure to sun or due to a pimple. is there any definite cure for this? will she be able to go out in the sun without pigmentation re-surfacing? can her skin go back to the way it was?

Lawrence Kass, MD · Answer

In my opinion, the Hyperpigmentation after a chemical peel is NOT permanent. Unfortunately, your mother may have a tendency toward this, as noted by one of my colleagues. This may have nothing to do with the peel (and I recognize that neither I or anyone else may be able to convince you of this) and that she just has to be EXTREMELY careful with using sunscreen on these areas and avoiding excess sun exposure.

Jeffrey Zwiren, MD · Answer

You are developing a post inflammatory hyperpigmentation.  Treatment for this type of problem includes the use of hydroquinone 4 to 8 %, Kojic acid, Retin-A, Topical steroid creams.  You can expect it to take up to 10 weeks for the pigmentation to clear. 
	Also available from a compounding pharmacy is Klingman's formula which is a mixture of all of the above chemicals.

Edward E. Dickerson, IV, MD · Answer

Hypopigementation is a permanent skin condition.  Once the melanocytes is damaged there is no way to correct it.  You can cover the spot with makeup to blend the spot into the skin tone around it.

	"Dr.D"

Jo Herzog, MD · Answer

Sounds like your mom makes quite a bit of pigment on her own and I doubt that the prior peel is what the cause of this is now . Hormonal changes or changes in or oral contraceptives might be changing the way she reacts to the sun but she probably has enough her own pigment for this to happen with small amounts of sun or inflammation anyway. She should apply sunscreen every morning and she might want to use a bleaching system when needed. Sunscreen is key!!

Laura E. Skellchock, MD (in memoriam) · Answer

Pigmentation is due to genetic tendencies, sun exposure and hormones. Both thyroid problems and estrogen imbalance can cause exaggerated hyperpigmentation in susceptible individuals. I think you need to see a cosmetic dermatologist who understands hormone metabolism. Have you been told if the pigmentation is in the epidermis, the dermis or both? This is an important question to ask your physician. The only laser I have had success with in treating hyperpigmentation reliably is the 532nM KTP laser. You MUST wear sunblock every single day - and I'd suggest one that is a physical block only, since sub-clinical inflammation (often from chemicals in sunscreens) can potentiate the hyperpigmentation. Good luck!

Is Hyperpigmentation Due to Chemical Peel Permanent?

Answers (5)