Freckles Got Darker After Second IPL Treatment

Question

I had my 1st IPL a while back for my freckles & 2 hrs later my freckles immediately looked like "pepper" & they peeled off 7 days later. Yesterday I had 2nd treatment w/ increased settings but spots did not "pepper" like last time. They just got darker but not flaky. Does that mean it didnt work?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

David Q. Santos, MD · Answer

Intense Pulse Light therapy directs it effect on darker pigment tissue.  Essentially the melanin is treated and the overall aspiration is to diminish the hyper-pigmented areas such as freckles.  Almost immediately after the IPL therapy the freckles will become darker and this essentially indicates effective treatment.  As the days and weeks go by, the freckles should soften more and more and ultimately hopefully achieve the desired result.  Mild darkening is satisfactory, severe darkening may indicate too heavy of an IPL therapeutic dose but generally pigmentation issues can be resolved with a tincture of time and sometimes topical medication such as hydroquinone can benefit to softening the darker pigmented problems.

Peter J. Malouf, DO · Answer

Assuming the settings were same, this does not mean it did not work.  I would bet that since you had more pigment (hence more target) the first time, you probably had more heat absorption and thus more peeling the first time than in the subsequent treatment.

Freckles Got Darker After Second IPL Treatment

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Freckles Got Darker After Second IPL Treatment

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