Post Inflammatory Hyperpigmentation After Fraxel 1927, Is this Permanent?

Hi I had fraxel 1927 for two spots on my cheeks, more like little age spots and freckles. Fraxel made me get hyperpigmenation. I now have two dark small patches on my cheeks, The physcian wanted to do Revlite Q Switch, Instead I went and saw a dermatologist who has prescribed hydroquoinine 4% with other ingredients in it, this leaves spots red, she has now given me Finacea. I had this in January 2011 and its now nearly 11 months and my spots have not faded or gotten any better? Is this perm?

Doctor Answers 2

Post inflammatory hyperpigmentation is not permanent,but does require treatment

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Fraxel 1927 is an excellent treatment for removal of uneven pigment because it is rather non-inflammatory.The reason PIH occurs is because it is a response of pigment cells to inflammation.More melanin is made to protect the skin,as it acts as an anti-oxidant as well as an absorber of UV basically the new pigment forme as part of a wound-healing response.Once it is there, it is not only in the surface layer , but also just under the surface- itis this part that cn be difficult to get rid of.Usuallly when such a long time period has gone by this needs to be a 2 step process - one to get rid of the existing pigment (low intensity 1927 or one of the q-switched or long-pulsed lasers) and then a phase of treatment with creams to block inflammation and block pigmantation.It is rather complicated so you really need to have a dermatologist who is expert in this area

San Diego Dermatologic Surgeon

Fraxel Laser

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At the least, this may be long term.  Depending on your skin type,  several laser options may exist like 755, IPL, or 532.  Creams are the safest, and several peels exist that can reduce the color.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

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