Infection after Fraxel caused hyperpigmentation. Cannot use hydroquinone. How can this be fixed fast? (Photo)

Question

I had a bacterial infection 3 days after fraxel. It lasted about a week. The skin around my mouth went from red to pink to brown. I’m about 3 weeks post procedure. I’m pretty much allergic to topicals like hydroquinone. Please, someone tell me how to fix this fast. I’m miserable and my doctor doesn’t care. I’ve become a recluse and I just want my life back. I had no idea this was even a possibility, had I been informed I wouldn’t have went through with fraxel.

Jason Emer, MD · Answer

Hyperpigmentation can be improved with a combination of Cosmelan, lasers, Aerolase, microneedling/prp, skin lightening, peels, and skin care. Sun protection is essential. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Harold J. Kaplan, MD · Answer

Hi Vanessa, very sorry to hear about your situation.  Sometimes even without infection, the body can produce excess pigment during the healing process from laser resurfacing. Usually we also suggest hydroquinone and we are curious to ask about what happens when you use it?  If you get red, irritated and itchy, this could be one of two things.  First, you could be allergic to hydroquinone itself and in our experience this is mostly with Hispanic patients.  You could also be sensitive to the Retin A that is usually in bleaching formulations.  In this case, we would suggest a bleaching formulation without Retin A (which we use at 4%, 6% or 8% HQ).  The other option is to use a weaker hydroquinone without Retin A (think "lightening cream" at Target or Macy's) and incorporate a 1% hydrocortisone itch cream to calm the skin while you are using it.  Finally, we use q-switched lasers to gently fade the pigment as well.  Best of luck.

Infection after Fraxel caused hyperpigmentation. Cannot use hydroquinone. How can this be fixed fast? (Photo)

Answers (2)

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