1 months post op Fraxel Laser, I am left with post inflammatory hyper pigmentation. Is this normal? (photos)

I got Fraxel Refine on the highest setting on my self inflicted scars approximately 1 month ago. It has finished peeling and now I am left with what looks like Post Inflammatory Hyperpigmentation. Is this normal and will this fade? I have asian skin.

Doctor Answers 5

Post Inflammatory Hyperpigmentation from Fraxel in Asian skin

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Fraxel is a fabulous laser for treating sun damage, fine lines, sun spots, acne scars and overall skin tone and texture. Asian skin is very sensitive and not all lasers were designed to treat type IV skin.  I would return to your treating physician for evaluation and help with treating this hyperpigmentation.  For the best cosmetic results please consult a board certified dermatologist with experience with Fraxel laser.

PIH in darker skin tones

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PIH is typical in darker skin type after aggressive lasering. Your treatment provider should guide you in using skin lighterners to help combat your PIH in a timely manner. 

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 20 reviews

Hyperpigmentation after Fraxel

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Post inflammatory hyperpigmentation, while undesired, is not an unusual side effect from Fraxel when treating Asian or darker skin.Sun protection and topical creams like hydroquinone and others can help lighten the dark areas more quickly. The majority of cases do fade to normal over time. See your dermatologist about a prescription for some fading cream.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Fraxel left hyperpigmentation on arms in Asian skin

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That is postinflammatory hyperpigmentation (PIH).   Usually occurs 3-4 weeks after treatment. It can be improved with topical hydroquinone and Retin A. Protect from the sun. It has been shown that pre and post treatment hydroquinone is very good at prevention of hyperpigmentation. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Post Inflammatory Pigmentation

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It certainly looks like Post Inflammatory Pigmentation (PIP).  This is very common in Asian skin.  Most cases will settle spontaneously but it will take time - up to 12 months.
It is very important to protect your arms from sun exposure both out of doors and even sitting in a car using broad spectrum SPF 50 sunscreen or preferably long sleeves.
You may want to see a Dermatologist regarding the possibility of using a pigment fading cream.

Phillip Bekhor, MBBS, FACD
Melbourne Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.