Is uneven blanching following pulsed dye laser permanent? (Photo)

Question

My doctor used a pulsed dye laser on some areas of post-sclerotherapy blushing on my thigh (the darker areas in the picture). She said that she used one setting for those areas and another setting for the "underlying redness" as she called it. Is this uneven skin blanching surrounding the blush spots seen in the picture permanent or will my overall skin tone blend in again? Is this hypopigmentation due to lack of melanin or it just looks lighter because there are no more capillaries in the area?

Will Richardson, MD · Answer

Discoloration following PDL is multifactorial and can be temporary secondary to inflammation and healing to permanent secondary to having part of the energy absorbed by superficial pigments in the epidermis, as opposed to the intended pigments deeper found in vessels.  Recommendation is sunscreen and time.  Hang in there. Dr. Will

John B. Lazor, MD, MBA, FACS · Answer

It is not uncommon to experience some pigment change/bruising after pulse dye treatment of the legs.  I find that the superficial skin changes on the legs stay around longer than on the face and neck.  Avoid sun to the area (make sure  you wear sun screen).  It should improve with time

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