Lasers to Treat Hyperpigmentation from Sclerotherapy?

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?

Doctor Answers 6

Sclerotherapy and dark spots

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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.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Hemosiderin is hard to fade

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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.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

How to lighten the dark spots from Sclerotherapy

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Think in terms of improvement, and not perfection because that is most likely all that will happen. First line treatment would be topical, prescription strength hydroquinone. You would have to apply this with a fine applicator and be sure to hide from the sun with an SPF of 55 (available from aveeno, neutrogena and others). If this is not successful the treatment might include intralesional steroid or even cryotherapy if you don't't mind trading a dark spot for a light spot.

Don't forget that you can wear leg makeup instead of not wearing the clothes that you want to wear!!!


Hope this helps.

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon

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Hyperpigmentation after Sclerotherapy for varicose veins

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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. 

Craig Crippen, MD
Kelowna Physician

Laser for hyperpigmentation after sclerotherapy

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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. 

Lasers for Hyperpigmentation after Sclerotherapy

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Post-inflammatory hyperpigmentation, especially on the legs in darker skinned people, can fade very slowly but 1 1/2 years is a long time to have waited. I have seen improvement of this problem using our long pulsed Nd Yag laser so I would recommend you try this next. But go slow - have only a few test areas done first to make sure it works or does not make it worse!

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

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.