How Long Will It Take PIH Caused by IPL to Resolve?

I had IPL on my neck, shoulders and chest with an Alma Hamony device. I experienced good results with my first treatment, but the energy level was increased for my second treatment, and it caused excessive heating and PIH in three areas (shoulders were fine, but the sides and back of my neck were not). I have been battling PIH for three months now. I have tried a combo kojic acid, glycolic acid, Retin-A, and hydroquinone, with little success except skin mottling. Will it ever resolve?

Doctor Answers 5

PIH after IPL

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I would try combination of  hydroquinone 4%, tretinoin 0.1% and Floucinolone 0.01% cream (all combined together). This is the Triluma formula. Try it for 2 months and then look at the result. Dr. Behnam

Santa Monica Dermatologic Surgeon

Hyperpigmentation after IPL

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Other options to consider are trying a stronger hydroquinone percentage such as 8% for a short time or a series of gentle chemical peels such as Jessner's peel.   Daily sunscreen use, at least SPF 30, preferably containing zinc oxide or titanium dioxide, is critical as well.  A series of low intensity IPL or Q-switched Nd:YAG laser treatments might also help.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Hopefully PIH will resolve

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PIH can happen post IPL when, basically, a light burn happens to the skin. You shoulders were probably fine because they have less sun exposure normally, but the sides and back of your neck are exposed more to direct and indirect sun. Hopefully the PIH will resolve with time, possibly even a year or so, but the truth is that every person is different and there's no tried and true way to resolve it. You need to use sunscreen daily as PIH becomes worse from sun exposure. The best way to resolve it might be to see a different office and have them start very light IPL to the spots where you have the PIH. This can help smooth out the different colors and spots and help it look better. But I'd only have this done by an extremely experienced office with lots of PIH experience; otherwise, you could even make it worse.

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IPL Treatment for Pigmentation and Sun Spots - Melaquin or IPL

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Identifying the source of discoloration is the first step in treating it.  Non-hormonal discoloration, such as Postinflammatory hyperpigmentation will generally take 6 months to a year to improve, even with IPL.  Hormonal based melasma will take longer.  In my Santa Monica and Beverly Hills practices, I prescribe Melaquin AM and Melaquin PM for all patients undergoing IPL treatment.  Melaquin enhances the effects of IPL. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

PIH...After IPL

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Time and and being diligent with the use of Hydroquinones and Retina-A's are your best bet.  Be sure to ALWAYS wear sunscreen. It is not uncommon for PIH to take up to a year to resolve.   


Good luck.


Dr. Grant Stevens 

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 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.