Hemosiderin staining after under eye fillers 5 years ago. Interested the lasers treatment. Advice? (photos)

The PicoSure General is an excellent laser for hemosiderin staining on any part of the body. Occasionally rhinoplasty patients develop hemosiderin staining to the undereyes and I offer a PicoSure General laser treatment to help lift the pigmentation. PicoSure General is a laser that is safe to use on all skin types ranging from 1-6. With that being safe it is safe to use on people of color without the concern of hypo or hyper-pigmentation when used correctly by a trained professional. This laser can also be used to treat tattoo removal as you mentioned because it works to target the deep pigment and fragment it out. If a laser treatment is what you are seeking I recommend the PicoSure laser to address hemosiderin staining. Going forward, I would recommend you to complete multiple in office consultations with board certified experts to discuss your ideal aesthetic goals. This way, they can better assess your face and create an ideal treatment plan for you.

Best of luck,
Kian Karimi MD, FACS

this can be treated with peels, v beam, and clear and brilliant. see an expert and start enlighten peels and skincare now (see link)

this is post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream.

Hyperpigmentation from any type needs a combination approach of peels like cosmelan, enlighten and aerify,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimonthly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

The dark pigmentation under your eyes could be from hemosiderin or it could be post inflammatory hyperpigmentation. You are correct in being concerned about inducing more hyperpigmentation with the wrong type of laser. The safest bet for your skin type would be to use a picosecond tattoo removal laser. There are other options as well such as micro needling, RF micro needling, PRP injections or fat injections. All of these treatments except the fat injection typically require multiple session for best results.

Tattoo lasers due carry more pigment risk. A 1540nm laser such as Palomar offers the best option. Non-ablative 1540nm laser typically repeated monthly until desired result.