I have melasma or PIH from laser. Underneath are some broken capillaries. Is it safe to do V Beam even though it's in the spot?

Question

Been using hydrocodone pads 4 percent for r days looks a little darker

Raffy Karamanoukian, MD, FACS · Answer

PIH is a process that is quite common after surgery. Known as post-inflammatory hyperpigmentation, PIH can make your scars look far worse than they should be. We can develop PIH after acne scars and after surgery, particularly if you have darker complexions. In clinical practice, we always begin with application of Melarase AM and Melarase PM creams (coupled with Melapads) to help smooth out the color and pigmentation. Once the creams are started, lasers can be used to further reduce the scarring. 
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Jason Emer, MD · Answer

This is difficult to answer without pictures and needs an in-person evaluation. Hyperpigmentation and broken capillaries need a combination approach for improvement. I recommend a combination of lasers (VBeam, ProYellow, Excel V, Tattoo), Aerolase, microneedling/prp, skin lightening, peels, and skin care. Sun protection is essential. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Payman Kosari, MD, FAAD · Answer

There is strong belief that melasma can be associated with a vascular component contributing to the brown seen in melasma.  As such, there is evidence to support the use of combination therapy of pulsed dye laser with a device used to specifically address the brown (toning with a qs laser, low level fractionated device, etc).  I have used the Vbeam in combination with other lasers safely to treat melasma.  Best of luck!

Suzanne Kilmer, MD · Answer

Yes, it would be safe to treat with VBeam.  Melasma also has a vascular component so
may even help. Make sure your doctor is very comfortable with the laser
treatment.

Sameer Bashey, MD · Answer

V beam or PDL is a laser and is based on using heat to destroy blood vessels. While there is a cryospray to help cool surrounding tissue, post-inflammatory pigmentation can be seen in V beam. It is advisable to pre-treat the proposed area with a cream program prior to use to prevent unwanted pigmentation and potentially scarring.

I have melasma or PIH from laser. Underneath are some broken capillaries. Is it safe to do V Beam even though it's in the spot?

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