Lasers to Treat Hyperpigmentation from Sclerotherapy?

Question

I'm 30 yr old active woman w/ multiracial background of Irish, African American, Native American and Middle Eastern descent, I have dark hair and tan easily. I had 2 treatments for minimal spider veins that worsened during preg. the first 1yr1/2 ago and the last 1year ago. I got hpigmentaion the 1st time then was treated again and I still have it. my L leg was treated for spider veins and the R he says cross between a spider vein and varicose?(2 different solutions) my L leg is fine the R bad :( before not so bad, after terrible. so...sad, too embarrassed to wear shorts. are their any laser treatments to clear the hyperpigmentation that I have had for over 1 year 1/2?

Ron Shelton, MD · Answer

Darkening of the skin after sclerotherapy could be post-inflammatory hyperpigmentation but often this fades before a year and a half. If you see a board-certified dermatologist they may use a Wood's light to see if the color decreases which indicates a deep pigment such that lightening creams will not work. Lasers may improve the darkening but they can possibly risk burning the skin or just irritating it enough to stimulate pigmentation, so you get or worsen the condition you're trying to make go away! The other cause for darkening after sclerotherapy is iron deposition in the dermis from leaks of blood or if the tiny clots that occasionally are left in the vessel cause staining from the red blood cell iron, similar to a tattoo! The 1064nm. NdYag laser may help, but remember, there is always a chance it may worsen it. You could ask the doctor to do a test spot rather than treating all the spots that bother you in case it doesn't produce a good result.

John Landi, MD · Answer

There is no perfect solution for post sclerotherapy hyperpigmentation.  Q-switch laser and Nd Yag laser have had some success.  Most hyperpigmentation post sclerotherapy will spontaneously resolve and some could be permanent.  Avoid sun exposure in the hyperpigmented areas

Hratch Karamanoukian, MD, FACS · Answer

The Nd YAG laser may help but PIH (post inflammatory hyperpigmentation) can be reduced if you follow a regimen of wearing stockings for 3 months after sclerotherapy and also using 2 creams to reduce this hyperpigmentation. I recommend Slerovase and Scleroquin plus creams as well as Scler-x. Scler-x is post-inflammatory hyperpigmentation reliex complex.

Craig Crippen, MD · Answer

This is a common problem encountered by many patients after sclerotherapy treatment sessions. The best advice i can give to you would be to wait it out. Patience is key here. It will usually fade but can take many years to do so. I would not recommend laser therapy because it is so unpredictabale in the results you will achieve.

Mary P. Lupo, MD · Answer

This may not be melanin, but a pigment in blood called hemosiderin. It fades slowly. I have heard some patients get improvement with a long pulsed Nd Yag laser.

Lasers to Treat Hyperpigmentation from Sclerotherapy?

Answers (7)