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

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

Doctor Answers 5

Yes, but it does require time. Here is my recipe for PIH secondary to CO2 Laser.

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1. Time, time, time...this will fade
2. SPF 50 + 4 hourly- LRP my preferred brand of sunscreen
3. Stay out of the sun if possible.
4. Fading agents- Traditional HQ or Hydroquinone at 5-8%
5. Add Vitamin A creams as tolerated
6. 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 best

Dr Davin S. Lim
Laser and Cosmetic Dermatologist

Post Inflammatory Hyperpigmentation (PIH): management

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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.

Chien C. Kat, FRCS
Birmingham Plastic Surgeon
4.8 out of 5 stars 100 reviews


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

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

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Hyperpigmentation following CO2 laser treatment

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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!

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Treatment and prevention of skin pigmentation after Fractional CO2 laser skin resurfacing

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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.  

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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.