Upper Lip Hyperpigmentation After Laser Hair Removal

Question

I have developed hyperpigmentation on my upper lip area after 9 laser hair removal treatments. For the past 4 years, I have tried hydroquinone 4%, kojic acid, microdermabrasion, IPL, palomar laser, tretinoin and Obagi products. I never leave the house without using Elta sunscreen.

	The area above my lip is now drier than the rest of my face and I feel a burning, tingling sensation when I am warm. Makeup does not fully cover the dark shading. I have medium, sensitive skin and rosacea. I am 44 years old. I am at my wits end and don't know what to do at this point.

	I now have one plastic surgeon/skin specialist recommending Fraxel laser and one dermatologist recommending a chemical peel. Which between the two would work? Any suggestions would be appreciated.

Raffy Karamanoukian, MD, FACS · Answer

Upper lip pigmentation can be a result of hormones, inflammation, sun exposure, and laser treatments.  I would advise a prescription topical cream regimen twice daily.

Peter J. Malouf, DO · Answer

Ir,
It would be very important to see the extent of the hyperpigmentation and your skin type first, as well as establish whether it is melasma or post inflammatory hyperpigmentation.
In addition to religious sunscreen usage, it is also important to use sunscreens that are physical blockers and not chemical blockers.  The difference is, physical blockers actually reflect UV and chemical blockers absorb and convert UV to heat, which can make pigmentation (especially melasma) worse in appearance and symptoms. (look for zinc oxide, or titanium dioxide ).
As far as treatment, all you have mentioned are helpful. I think it is very important to realize, however, that chemical peels and lasers can result in hyperpigmentation in and of themselves.  I would start with Hydroquinone 4% + Hydrocortisone 2.5% + retin A .05% compounded by the pharmacist. This compound is usually 70% effective.
I would then work up to chemical peels and laser technology.

Upper Lip Hyperpigmentation After Laser Hair Removal

Answers (2)