How Should I Handle Hyperpigmentation from IPL Burns?

Question

I am an Asian female who underwent IPL to treat folliculitus and ingrown hairs. On my fourth treatment I suffered superficial burns on my bikini line, but was assured that they would heal. They did, eventually, but I was left with dark pigmentation marks on the area. When they did IPL on the same area to treat it, I got burnt again.
My therapist claims to have skipped the burnt area and claims confusion over what had happened. She advised me to use lavender oil to treat it but my GP and a pharmacist prescribed other creams for burns. How should I deal with these burns? Would you know if they would cause scarring and how I can avoid them on my next treatment? Thank you.

Lorrie Klein, MD · Answer

In my dermatology office in Orange County, Fraxel Dual with thulium wavelength seems to do the best job treating hyperpigmentation resulting after IPL and laser burns. I would also recommend you use Elure to help remove the pigmentation and a good 4% hydoquinone product like Obagi to reduce the recurrence of pigmentation.

R. Brannon Claytor, MD, FACS · Answer

Once the burns have healed and you still are left with darker pigmentation I would suggest using a skin lightening agent such as hydoquinone once every night to those areas.  It is best to speak with a doctor first on how to use this product and best to get the product from your doctors office as well. Hope this was helpful!

W. John Bull, MD · Answer

The settings for and IPL treatment should be greatly adjusted going forward when a patient gets a burn. Please thoroughly discuss your outcome with your provider so they are very aware and make the necessary changes in your treatment to avoid this from ever happening again. The best product to use on a burn to speed up healing time and minimize any scarring is TNS Recovery Complex from SkinMedica.

Steven H. Williams, MD · Answer

Initially, you can apply aquaphor a couple of times daily to the burns and let them heal naturally without picking at any scabbing or blisters. Sun avoidance is recommended to reduce worsening of any post inflammatory hyperpigmentation. Once the area is healed, skin lightening agents may be used such as hydroquinone. There are also non hydroquinone alternatives. These topical creams have to be used daily and consistently. Your clinician can instruct you on how to use these creams. The settings can also be adjusted to reduce the chances of reactions with the treatment or you can try a different hair removal machine, such as an Nd:yag laser that may be safer for your skin type and effective for hair removal. I recommend that you consult with someone for an alternative method since it seems that you are having issues with the IPL.

Sam Naficy, MD, FACS · Answer

It may be possible to improve the pigmentation by using lightening agents like hydroquinone bleaching cream. I recommend that you see a board certified dermatologist or a board certified plastic surgeon.

Sonia Badreshia-Bansal, MD · Answer

First, Asian skin is very demanding to treat safely for hair removal if the device or practitioner are compromised. I would not go back for a third burn.

	The spots should resolve in time if there was not blistering. When they are healed, a bleaching cream is a possibility to decrease the pigment formation. Discuss this with a Plastic Surgeon or Dermatologist and they will get you on track with a 1064 laser, or 810 Diode which is the more safe and effective laser to treat ethnic skin.

William Ting, MD · Answer

Laser burn will occasionally happen even in the hands of the most experienced nurses working in the most reputable medical clinic under supervision of board-certified dermatologist or plastic surgeon. The key is to have laser procedures performed in a clinic where the supervising physician has good insight and experience in medical dermatology to step in when there is a complication involving laser burn. All skin types may be susceptible to pigmentary changes after laser burn though they tend to go away much quicker among fair skin individuals. You need to lubricate the affected area and minimize further irritation and achieve consistent sun protection within 10 days after laser burn; after pigmentation is becoming evident, work with a board-certified dermatologist to lighten pigmentation with combination of hydroquinone, glycolic acid, vitamin C.

Harold J. Kaplan, MD · Answer

The first question we have is why you would be considering having another treatment with this practitioner after two that led to burns? Either the practitioner does not know how to use the device or your skin type is not a good candidate for the treatment. Either way you should not be going back fo rmore treatments.
As for how to deal with the current burn:

First address healing with antibiotic ointment to prevent infection.
Keep the area covered from sunlight to prevent further pigmentation.
Check in with your practitioner at least every few days if there are issues with healing.

Once healed there are several options for PIH (hyperpigmentation).  We use either and sometimes both to fix PIH problems.

Hydroquinone bleaching creams
q-switched laser treatments.

Finally, to address the issue of your ingrown hairs, IPL IS NOT the correct light based device. Long Pulsed Nd:Yg lasers are much safer and more effective for your skin type.  We suggest getting through the current burn situation and recovery with the current practitioner and then switching to a practitioner with the correct laser system when you decide to continue with your hair removal.

Robert W. Sheffield, MD · Answer

Thank you for your question. Based fromwhat you have posted, I gathered that you have acquired hyperpigmentation fromIPL burns. IPL after effects usually range from slight redness to swellingwhich should subside normally within 24 hours post treatment. Developinghyperpigmentation may be caused by the light intensity settings set by yourdoctor. Your doctor’s skill and experience with IPL may also play a role inexperiencing after effects such as hyperpigmentation.
Should you acquire such burns, it isadvisable to moisturize the area using topical creams such as antibiotic ointments.Moreover, sun exposure may also affect the severity of this. Another methodthat you can try to reduce the hyperpigmentation is to use hydroquinone. 
Should you opt to go for IPL treatments againin the future, make sure that you get to know more about your doctor. Make surethat he or she is a board certified plastic surgeon who has performed IPL andproduced good results from it. Skill and experience, especially in setting thelight intensity levels plays a huge factor in developing after effects or not.IPL is a fairly safe treatment method that should have little to no downtime atall.

Scott Chapin, MD, FACS · Answer

Anytime there is a burn on the skin from a
laser treatment it is best to keep it moist with topical ointment such as
Aquaphor, or an antibiotic ointment. Avoid the sun to that area as to not make
it more inflamed.  After it has healed
you can attempt to decrease the hyperpigmentation with a topical hydroquinone
cream.  As for future IPL treatments it
is best to choose a provider who is knowledgeable in the laser settings for
your skin type to avoid any complications. I would also recommend scheduling a
consultation with a board certified plastic surgeon.

How Should I Handle Hyperpigmentation from IPL Burns?

Answers (13)