Long-term hyperpigmentation 10 years after Pico laser tattoo removal (photo)

Question

I had approximately 6 times or more pico laser treatments for 10 years ago. The color has completely been gone, but the shape has been the same as before. Is this hyperpigmentation? I have been using tretinoin cream 0.1% and hydroquinone cream 4% for a month, but haven't seen any improvement. How can I treat to remove this?

Anna Chacon, MD, FAAD · Answer

Long-term hyperpigmentation after laser tattoo removal can be challenging to address, especially if it has persisted for such an extended period. Here are some considerations and potential treatment options:

Understanding Hyperpigmentation:
Hyperpigmentation after laser treatments can occur due to the skin's response to trauma, resulting in increased melanin production. This might explain why the shape of the tattoo remains visible even after the color is removed.

Current Treatment Approach:
You're already using tretinoin and hydroquinone, which are standard topical treatments for hyperpigmentation. However, these can take several months to show significant improvement, and patience is essential.

Additional Treatment Options:
Chemical Peels: Professional chemical peels can help exfoliate the skin and reduce hyperpigmentation over time.
Laser Treatments: Other laser treatments, such as fractional lasers or Q-switched lasers, might be effective in targeting stubborn hyperpigmentation.
Microneedling: This can help stimulate collagen production and improve skin texture and pigmentation.
Topical Agents: In addition to tretinoin and hydroquinone, consider incorporating other lightening agents like azelaic acid or vitamin C.

Consultation with a Dermatologist:
It's crucial to consult with a dermatologist who specializes in pigmentation issues. They can assess your skin condition and recommend a tailored treatment plan.

Sun Protection:
Consistent use of broad-spectrum sunscreen is vital to prevent further pigmentation and protect the skin from UV damage, which can exacerbate hyperpigmentation.

Monitoring and Patience:
Monitor your skin’s response to treatments and maintain regular follow-ups with your dermatologist to adjust your regimen as needed.

Addressing long-term hyperpigmentation can be a gradual process, but with the right combination of treatments and professional guidance, improvement is possible.

Paul Flashner, MD · Answer

Hello,
Yes, this is Hyperpigmentation from tattoo removal. This is common following treatment. We can also use Pico laser to treat this (hyperpigmentation).

Barbara Padilla, MD · Answer

At our practice we use Pico Genesis for hyperpigmentation. This laser removes hyperpigmentation. We recommend 1-3 treatments 8-12 weeks a part. This allows your body break down the pigment and exit through the lymphatic system.

Long-term hyperpigmentation 10 years after Pico laser tattoo removal (photo)

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Long-term hyperpigmentation 10 years after Pico laser tattoo removal (photo)

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