Hi doctors, 2.5 weeks post picoway and pigment is worse. DX is ABNOM/Nevus Horis/Horis Macules. Via biopsy, my dx is ABNOM/Nevus Horis/Horis Macules. I have had a handful of q-switch 1064 treatments and 2 pixels. Recently, I had a picoway session, it's 2.5 weeks post - my face is worse. Pigment is darker, with pink areas. On my nose bridge, I had very light pigment, barely noticeable, now there are dark brown spots. Appreciate any advice, would like to know if this is a common process with the Picoway. Should I do more sessions, how do I get rid of the pigment? Please help. TIA.
July 24, 2019
Answer: Worse pigment post PicoWay I will tell you that I've had a handful of patients who got worse pigment for about a month after PicoWay and then everything resolved and settled down, and they look great. This occurs because the PicoWay actually causes the pigment to surface and rise up - which means darken. We did do multiple treatments and the inflammatory response only occurred after the first one. Now with that being said, I've never treated anyone to the degree and redness to which you were treated. I certainly would have sent you home with hydrocortisone to apply immediately and for a few days, and may have post treated you with some kind of HQ as well. But, I have had patients with an inflammatory response who later actually had a great response. I would assume this is not the first time your provider has used the PicoWay system and that they have good experience and know what they're doing. I would suggest follow up with your treating office to make sure this is what they were expecting. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
Helpful 1 person found this helpful
July 24, 2019
Answer: Worse pigment post PicoWay I will tell you that I've had a handful of patients who got worse pigment for about a month after PicoWay and then everything resolved and settled down, and they look great. This occurs because the PicoWay actually causes the pigment to surface and rise up - which means darken. We did do multiple treatments and the inflammatory response only occurred after the first one. Now with that being said, I've never treated anyone to the degree and redness to which you were treated. I certainly would have sent you home with hydrocortisone to apply immediately and for a few days, and may have post treated you with some kind of HQ as well. But, I have had patients with an inflammatory response who later actually had a great response. I would assume this is not the first time your provider has used the PicoWay system and that they have good experience and know what they're doing. I would suggest follow up with your treating office to make sure this is what they were expecting. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
Helpful 1 person found this helpful
