Can Post CO2 Laser Treatment Hyperpigmentation Be Treated? If So, How?

In my Santa Monica and Beverly Hills plastic surgery practice, I place my Fractional CO2 and chemical peel patients on a periprocedural skincare regimen that includes MelaClenz, Melarase AM, and Melarase PM.  Melarase AM contains four active sunscreens that block UVA and UVB radiation as well as skin lighteners.  Melarase PM contains skin lighteners and enzyme blockers that minimize postinflammatory hyperpigmentation.  

Thank you for your message! Hyperpigmentation is a risk after laser procedures though typically will fade with time. We emphasize the importance of staying out of the sun after these procedures whether hyperpigmentation occurs or not, so make sure you have a high grade SPF sunscreen. Certain lightening agents such as hydroquinone and retinols an be used to help fade darker spots. Gentle peels or Erbium lasers can also be used, though there is a risk of further hyperpigmentation with this as well! I would recommend following up with your provider.  

Patients with darker skin types stand a higher risk of PIH with not just laser treatments but pretty much any treatment which trigger an inflammatory response in the skin. As such, matching the right treatment for the patient and preparing the skin are POF paramount importance.For patients with darker skin types who need CO2 laser treatment, I'd routinely start them on a skin care routine that involves SPF and hydroquinone for 6 to 8 weeks before starting laser treatment. Bear in mind that preparation only reduces the risk but cannot eliminate the chances of PIH.The treatment of PIH consists of good uv protection, suppression of pigment formation with hydrquinone or other brightening agent and retinol. Chemical peel may be required for deeper pigmentation. And allow plenty of time for natural recovery and for the treatment to work.

First ask your doctor. Otherwise consult a qualified medical ski care professional/ Lightening creams are your best bet here.

While it is not a common event to have hyperpigmentation following either traditional CO2 resurfacing or fractional CO2 resurfacing, it is not uncommon.  Factors that influence post-inflammatory hyperpigmentation include your skin color, type of procedure, healing time, location on the body treated, sun exposure and skin care.  First, make sure to see your doctor that performed the treatment so they know what is happening.  They can place you on topical creams that will help to decrease pigment formation and to help decrease the pigment that has already formed.  Prescription strength hydroquinone, often combined with retin A and a steroid, tends to work the best.  Other types of lightening creams can be used in combination with the hydroquinone to achieve maximal results.  Other types of treatments such as peels, microdermabrasions, etc can also be added depending on the location and response to topical treatments.  Strict sun avoidance is important to prevent the pigmentation from getting worse.  Good luck!

1. Time, time, time...this will fade2. SPF 50 + 4 hourly- LRP my preferred brand of sunscreen3. Stay out of the sun if possible.4. Fading agents- Traditional HQ or Hydroquinone at 5-8%5. Add Vitamin A creams as tolerated6. Add Lytera 7. Gentle peels- Glycolic 20%, increasing as tolerated. Lactic acid, or high strength Vit A peels. 8. TCA peels at 6-8 %9. Laser Q switch 1064, low fluence. PIH form CO2 is a common occurrence and a good dermatologist can help you. All the bestDr Davin S. LimLaser and Cosmetic DermatologistBrisbane Australia.