What is the best way to get rid of PIH after Fraxel dual for brown skin?

Question

I had a fraxel treatment done on my cheeks four weeks ago. I started to notice PIH after 2nd week of treatment. I went back to my dermatologist and she prescribed me Obagi clear. It seems like the PIH is getting darker and darker every single day and it's very depressing. Make up does not cover it either.

Jason Emer, MD · Answer

I suggest seeing an expert for treatment.  This requires aggressive sun protection and lightening creams.  Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

In my practice, I try to stay away from these combination regimens, as cortisones are non-selective inhibitors of melanocytes.  I would recommend my patients to start Melarase AM and Melarase PM for the pigmentation.
I would start with an intense skin rejuvenation protocol for age spots that includes fractional laser, Covalent chemical peels, and daily skin brightening creams to improve your skin’s complexion. Laser therapy, he adds, must be combined with a proper skin regimen to enhance and maintain youthful results.
He recommends the following skincare products for dark age spots: Melarase
MelaClenz Brightening CleanserMelarase AM: Day-time skin lightener with SPF 30Melarase PM: Night-time skin lightenerMelapads: Daily Exfoliating PadsReplenish Retinoid Cream: Exfoliating and skin-stimulating night creamBest, 
Dr. Karamanoukian
Realself100 Surgeon

Michele S. Green, MD · Answer

Fraxel is a great laser but should not be used on patients who have type IV skin.  Please consult an expert for bleaching creams and the proper skin care treatment.  Best, Dr. Green

Lenore Sikorski, MD · Answer

At our clinic we typically recommend a compounding prescription of Retin A 0.05% with hydroquinone 5% at night and an additional 5% hydroquinone in the am. If there is no response then we increase to 0.1% Retin A and 8% Hydroquinone in the evening. I would recommend you see a board certified dermatologist to prescribe you a bleaching cream for these areas of concern.

Steven F. Weiner, MD · Answer

This is treated with hydroquinone, at least 4% and Retin A. If no improvements are noted after a few weeks, go up to 6% hydroquinone.

Davin Lim, MBBS, FACD - Account Suspended · Answer

1. Time2. Sunscreen ++++ Spf 50 at least twice a day3. Use HQ 5-7 %, nightly if tolerated4. Option for gentle chemical peels5. Option for gentle QSL Q switch lasers6. Option for Picosure FOCUS- start with 8 mm, down to 6 mm. Multiple treatments. This will take time to settle. All the bestDR Davin Lim Laser Dermatologist, Brisbane, Australia.

What is the best way to get rid of PIH after Fraxel dual for brown skin?

Answers (6)