Hyperpigmentation / hypopigmentation after a fire burn. Should this be treated soon and what are the best options? (Photos)

Thank you for providing such a detailed history. Post-burn pigmentation changes—both hyperpigmentation and hyperpigmentation, are common following even superficial burns, especially on the face and arms. It’s encouraging that the wounds have already closed and you're in good overall health, which supports healing.

When it comes to treating pigmentation changes, timing does matter. The early post-inflammatory phase (first 3–6 months) is a critical window where gentle treatments, strict sun protection, and hydration can help support more balanced pigment restoration and minimize long-term discoloration.

Your dermatologist’s advice to start with a gentle over-the-counter product like Eucerin Radiant Tone is reasonable. These products often contain ingredients like Thiamidol or other tyrosinase inhibitors that can help regulate pigment without causing irritation. More potent treatments like hydroquinone, kojic acid, or tretinoin may be considered later if the discoloration persists or worsens.

Sun exposure without SPF can significantly worsen hyperpigmentation and also delay or even prevent repigmentation in hypopigmented areas. UV radiation triggers melanin production unevenly and can also cause DNA damage in already compromised skin, which is why daily broad-spectrum sunscreen is essential, even when indoors or on cloudy days.

It is possible that your pigment may continue to improve over time, especially in the next 6–12 months. However, early supportive care and avoidance of triggers like sun exposure can make a notable difference in your outcome. If hypopigmented patches persist beyond one year, options like fractional lasers, microneedling, or targeted pigment-stimulating treatments may be considered to help restore color.

In your case, staying consistent with sun protection and gentle topical treatments now gives you the best chance of natural pigment normalization while preserving the option for more aggressive interventions later, if needed.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Sun exposure without sunscreen can cause significant skin damage, including sunburn, premature aging, and an increased risk of skin cancer. One common concern after sunburn is post-inflammatory hyperpigmentation (PIH), where the affected skin becomes darker than the surrounding areas. This pigmentation can persist for months and sometimes longer, depending on skin type and the depth of the burn. I recommend daily sunscreen use, even on cloudy days or when indoors near windows, to protect the skin from further UV damage and to prevent worsening of pigmentation. In addition to strict sun protection, I often recommend considering treatments like Pico laser therapy, which can effectively target and break down excess pigment in the skin, helping to restore a more even complexion over time. This type of laser is gentle and suitable for many skin types, often resulting in faster and more reliable improvement compared to waiting for pigmentation to fade on its own. I hope this helps and best of luck!