PIH After Fractional C02 Happens on Epidermis or Dermis ?

Hi, I wanted to know when a Post Inflammatory Hyper-Pigmentation happens after a Factional CO2 laser. is it on the Epidermis or Dermis. If it is on the Epidermis how easy it is to get away with it and if it is on the Dermis how tough it is to get it off and what is the time period ? Thanks

Doctor Answers 2

Tips to improve results after Fractional CO2 laser and decrease risks of Fractional CO2

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Absolutely a great question!  Post-treatment hyperpigmentation can occur as a result of both dermal and epidermal melanin.  Melanocytes are located within the epidermis and perivascular infiltration of pigment can occur into the dermis.  After Fractional CO2 laser or Chemical peels, I always recommend a skincare protocol that includes Melarase AM and Melarase PM.  Melarase AM has skin lighteners as well as FOUR active sunscreens to block the effects of UV radiation.  Further Melarase PM works as an enzyme blocker for pigment production. 

Post inflammatory Hyperpigmentation

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The epidermis is made up of flattened dead skin cells being pushed off. It the pigmentation was limited to the epidermis it would have been easy to get rid of it with simple methods such as salon microdermabrasion. That is not the case. The pigment cells are deep in the dermis and the process in present in the mid and deep layers of the dermis. Correcting Hyperpigmentation is not an overnight process and involves the judicious use of bleaching creams and sun block. 

Peter A. Aldea, MD
Memphis Plastic Surgeon

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