Chemical Peel for Pigmentation After Mixto Laser?

Four weeks after Mixto laser treatment, my cheeks are still pigmented. The pigmentation appears like the lines on the areas treated with the high set energy of the laser. The doctor looks confused and says it takes months to disapear.

The process of healing was all normal, no problems. But now my skin never went back to normal before laser. He wants to speed the process of "turning to the normal colours" with chemical peel because I cannot leave the house without makeup on my cheeks. Will it help with the pigmentation?

Doctor Answers 5

Chemical peel after Mixto

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The Mixto laser works exceptionally well to not give hyperpigmentation. We put all or our patients on an exfoliater such as 10% glycolic acid along with 6 to 8% hydroquione for one month before laser resurfacing to prevent this complication. However, in dark eyed patients who tan easily it is still possible to get some pigmentation. We restart our skin lightening regimen about 2-3 weeks after surgery. On a rare occasion we will do Foto Facial with broad bandlight. Chemical peels are more likely to irritate skin and increase pigment.

San Ramon Dermatologist
4.2 out of 5 stars 5 reviews

Pigmentation after Mixto laser

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Pigmentation can occur after any laser or chemical peel. It is a response to inflammation. We called this post-inflammatory hyper-pigmentation. The first step is to use topical lightening agents (ie Retin A , hydroquinone, etc.) There are peels specifically for pigmentation, (ie cosmelan peel) that doesn't actually peel the face but instead gives an intense burst of lightening agents on the skin. So, my first step includes finding the most effective creams to reduce pigmentation. It can take a couple of months to resolve this. There are other treatments, but that would be after exhausting the various cream options.

Lenore Sikorski, MD
Orange County Dermatologist
4.4 out of 5 stars 25 reviews

Pigmentation after Mixto laser

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The hyperpigmentation which occurs following fractional CO2 laser resurfacing can be treated with topical hydroquinone (bleaching cream) and tretinoin (retin-a). Care should be taken with these agents to avoid irritation. I would not recommend a chemical peel at this time as it may place you at risk for more pigmentary problems. If you are going to get a peel, a light peel would be preferable. In any event, the pigmentary issue should gradually resolve with time.

Bryan K. Chen, MD
San Diego Dermatologist

My first step is bleaching agents or steroid creams

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Greetings Zaneta,

I use the Mixto system in my practice. Pigment irregularities after laser resurfacing can occur and will often resolve with time. In my practice, I avoid any type of skin resurfacing procedure for at least three months after laser treatment. For patients who suffer from hyperpigmentation I prefer to use bleaching creams and sometimes steroid creams to correct he problem. Should it persist longer them 3-6 months, I think a medium depth peel such as 35% TCA would be a reasonable suggestion.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Pigmentation after laser treatments can be successfully managed

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Hi there-

Certain skin types are at higher risk of this than others, and your lifestyle can also affect your risk of developing this problem. Conversely, the Mixto's advanced technology LOWERS your risk.

Now that you have the problem, I would talk to your provider about gentle bleaching of your skin using a combination of Retin-A and hydroquinone.

I would NOT pursue a chemical peel, as this type of treatment would be too aggressive on your freshly healed skin.

I would also reassure you that over time you should be able to expect this to completely clear up, so take heart.

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.