PicoSure laser on my melasma left me with PIH (post inflammatory hyperpigmentation).

Question

I had PicoSure done on my melasma underneath my eyes and it was awesome. Fast forward a month and a half, I did a second treatment of it. It left my skin darker, redder, and worse. FYI the same person did it both times. I visited another doctor to treat this, and I’m about a week into a treatment of hydroquoine 8%. The PIH is still there, just slightly better. - Can any laser help my PIH/melasma now? Will my PIH ever fade? - Would you ask for your money back from the doctor who gave me PIH?

Harold J. Kaplan, MD · Answer

Hello JST.  We do not advise patients to get q-switched laser treatments because too often, the side effects you are describing occur.  In addition, because there is no cure for Melasma, q-switched laser treatments like the Picosure are just more expensive and higher risk treatments for a condition that needs maintenance treatment.  We also use 8% hydroquinone, but in a liquid gel form.  Results can be seen at the link below.

Brian K. Machida, MD, FACS · Answer

Melasma is difficult to treat with any laser.  I usually make sure that the pigment problem lightens before another session is done.  The PIH will likely get better.  Responses like this are unpredictable, but the Picosure is probably the safest laser to try.

PicoSure laser on my melasma left me with PIH (post inflammatory hyperpigmentation).

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