What can I do about hyperpigmentation caused by Infini radiofrequency microneedling? (Photos)

Question

I had infini microneedling to help me with hyperpigmentation and acne scars. Two weeks post procedure I have rectangular hyperpigmentation marks all over my face. I had to prepay for three procedures and I have two left. I have tried to using bleaching products on my face but they are irritating my skin and not helping. Will this hyperpigmentation ever fade? What lightening products should I use given that my skin is sensitive? Is it a bad idea to go through the two remaining infini procedures?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I am really sorry that you are experiencing this problem. As you probably have already learned by now, there are unfortunately other similar posts to yours, particularly by individuals with skin of color, regarding the same problem that you describe after treatment with radiofrequency devices (as well from other light and energy-based devices).  For more than a half-dozen years already I have been consistently warning readers to do their "due diligence" before undergoing treatment with these relatively expensive supposedly "next big thing" "bells and whistles" devices that have come along for whose benefits serious, hard science is unfortunately still lacking. There are however relatively inexpensive methods for treating acne scars, which include subcision +/- biostimulatory fillers for sunken boxcar and rolling scars, TCA CROSS for ice pick scars, microneedling (accompanied by the appropriate topical application of skin lightening or skin repigmenting agents--depending upon the specific circumstances) for post inflammatory hyperpigmentation problems, as well as superficial peels for lightening postinflammatory hyperpigmentation, such as you apparently are experiencing right now, along with an at-home regimen of prescription strength bleaching agents. For more information on any of the above, you can check out the archives of RealSelf.com. Before proceeding, you would be wise to seek consultation with a board certified aesthetic physician. Best of luck.

Katherine Dee, MD · Answer

Hi there-- there is occasionally some transient hyperpigmentation after Infini. This can be prevented or mitigated against with skin lighteners that should be used for at least 4 weeks before the treatment and after the treatment until all treatments are done and any hyperpigmentation resolves. There are many options, so you will need to find one (or more) that does not irritate your skin. We use a prescription topical with hydroquinone, tretinoin, azelaic acid as active ingredients. We also have a non-hydroquinone option with kojic acid in it. You could also use SkinMedica Lytera, Vitamin C and Retinols. The pigment will resolve, but it can cake weeks to months. Ask your doc to help determine what options will best work for your skin.
Technique can affect this complication as well, as pulling up on the hand piece during the RF pulse can increase damage to the epidermis and stimulate more pigment production. Passes that are too superficial can have the same effect. Make sure the person performing the service has a lot of experience. 
Infini is a great treatment for acne scarring, and assuming you have a good relationship with this doctor, you can minimize this reaction with future treatments. I would make sure you get through this episode and can find topical lighteners that work for you and then consider finishing your package after it is resolved.

Davin Lim, MBBS, FACD - Account Suspended · Answer

This will fade in time. I know the company says that PIH will not occur, but this can occur if 1. Pulse of RF was delivered as the needles are retracting 2. Too superficial with too many passes 3. PD or energy levels are too high for the depth 4. Combination of above 5. If you have darker skin type or underlying conditions like melasma or prone to PIH. Solution as Dr Novick suggest is that one starts with sun protection, add SPF, HQ, and if needed healing lasers. Your dermatologist or plastics who performed this procedure will assist you. This is duty of care. Dr Davin Lim. Brisbane. Australia.

What can I do about hyperpigmentation caused by Infini radiofrequency microneedling? (Photos)

Answers (4)

Answer: HQ, Meladerm, sun protection, low dose laser (if needed)

Answer: HQ, Meladerm, sun protection, low dose laser (if needed)

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What can I do about hyperpigmentation caused by Infini radiofrequency microneedling? (Photos)

Answers (4)

Answer: HQ, Meladerm, sun protection, low dose laser (if needed)

Answer: HQ, Meladerm, sun protection, low dose laser (if needed)

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Recommended reading

Everything you need to know about Infini RF

Our mission is to create a world where every investment in modern beauty is Worth It.