I Had Light CO2 Fraxel Done Under my Eyes. I Am 4 Wks out and Have Hyper-pigmentation when Will It Go Away if Ever?

I asked for the lightest CO 2 Fraxel, because I was worried about hypo-pigmentation. I was red/pink and swollen post op and the pink faded, but I then developed hyper-pigmentation dark spots and over all half moon circles under my eyes and now look like a raccoon. The doctor said it will eventually go away and ordered hydroquinone 4%. I have used it 6 days and know it is probably still early to see any results. Will this discoloration resolve and return to my regular pigmentation? If so when.

Doctor Answers 2

Hyperpigmentation or Melasma?

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Hi Pinky.  We have seen this issue before.  Depending on your skin type, it may just be hyperpigmentation, but it could also be Melasma.  We have often see ablative lasers "bring out" Melasma.  Hydorquinone will help, but if it is Melasma, it will most likely be an ongoing concern her forward.   

If 4% hydroquinone does not work out well (give it 1-2 months) then consider finding a higher % which comes in a customized product.

Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Post inflammatory hyperpigmentation is not permanent,but does require treatment

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Pigment darkening after any inflammatory reaction occurs as an attempt by melanocytes( pigment cells) to protect the skin, because melanin is an antioxidant. The darker the natural skin color the higher the risk for this to happen.It is much like a tan except more intense and does require treatment to eliminate. Generally hydrquinone, retinol, topical Vit C and sunscreens are required. Most cases resolve within 2-3 months, but I have seen it persist as long as 12 mos even though it was being treated.Without treatment it can last for years.

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon

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