Dark Spots Recurring After IPL Treatment

I just had my third IPL treatment done and after the first week my skin looked really nice and free of the dark spots... finally.

On the third week some of the dark spot started to reappear. My doctor prescribe hydroquinone to treat them. I'm on my fourth week after the last treatment. Should I go for another treatment or should I just wait and see if the hydroquinone would help fade the spots?

At this point I just don't want to damage my skin or make it worse. Also is this pigmentation normal? I've been away from the sun all of this time. Would there be any other factor that may be causing this problem? Or is this normal on this Laser treatment? Thanks a lot for your help.

Doctor Answers 3

Depends on what the dark spots are

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Thanks for your question.

The answer to your question hinges on whether the dark spots represent melasma (not amenable to any kind of laser treatment to-date) or lentigos / sun damage (very amenable to laser treatment). Both of these hyperpigmentation conditions will worsen with sun exposure, and while melasma is known to come back after treatments, lentigos treated with laser usually do not.

Assuming that you simply have sun damage and lentigos, it is very possible that the sun exposure has highlighted newer lesions not noted before, or that you did indeed get new ones. The addition of hydroquinone is always a plus and should only help any of your IPL treatments. I do NOT believe that doing further IPL treatments will hurt you or your results. In fact, when treating for photodamage, some patients need up to 6 treatments depending on the severity, resistance to treatment, and the results.

If I were you, and you were happy with the first set of results, I would likely continue, use the hydroquinone, and of course, make sure that there is no melasma component.

I hope this helps!

Beverly Hills Dermatologist

Dark Spots returning after IPL treatments

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IPL does a wonderful job at removing sun damage and reddness to the surface of the skin. If it is superficial it does a great job, if its deep or possibly a case of melasma it helps but usually doesn't wipe it completely. It will lighten up the pigment in the areas but you may notice after time the areas will appear to show some darkening again. It is vital that you wear sunscreen an antioxidant and probably a product with hydroquinone to keep your skin results following our IPL looking great. It will not hurt your skin to use sunscreen and antioxidants always. It will protect your skin from further damage if used daily.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Recurrent "Dark spots" after IPL

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Now that you are on the hydroquinone you could procede with another session or two of IPL. There are varying results of the treatment of melasma with the Fraxel re:store and I have had some good results, some mediocre, but none worse. If it is not melasma, and just sun damage I have seen good to excellent results with the Fraxel re:pair.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.