Prolonged Post Inflammatory hyperpigmentation 8 months post co2 laser - how can I improve this? (Photos)

Question

Hi, I have had co2 laser on my face about 8 months ago. The procedure was not done by a certified doctor or nurse and the settings were obviously too high and have not healed at all. I have red/brown big squares still on my face now 8-9 months post procedure. It healed a little in the first 2 months and now has been slow and no progress. I am very concerned. I always put spf 50 to protect from sun. Please help me with what topical treatments I could use. I have tried hydroquinone, tretinoin and azaleic acid but feel like it irritates my skin more...I would need some help please

Carey Nease, MD · Answer

This is an unusual situation as most patients will heal before 6 months, even with some hyperpigmentation. Since you have tried several creams I would next try microneedling with either PRP or exosomes, which would be even better. Probably 3 sessions. A laser that can also help with the pigment is a pico laser or Q-switched laser that is commonly used for tattoo removal or melasma. Find a place near you that offers those treatments and when in doubt get the advice of a cosmetic dermatologist. Good luck!

Nelson Lee Novick, MD · Answer

Very aggressive, destructive treatments, such as CO2 laser, conventional dermabrasion, and deep chemical peels are well known causes of this kind of post-infllammatory hyperpigmentation. Without treatment, this problem tends to be persistent
Fortunately, professionally performed manual microneedling (no need for the added expense and risks of RF microneedling) can help to stimulate new collagen and elastic fiber production, which can help to improve this, especially when combined with the application of Rx pigment lightening agents, since the microchannels created allow for greater penetration than can be achieved via topical use alone. Typically, a more penetrating form of microneedling is needed here to achieve the desired results. So, best to seek professional care
You would be wise this time to consult with an experienced, board certified cosmetic dermatologist who can both treat your problem in-office, as well as prescribe a proper at-home treatment regimen to complement the in-office treatments. Best of luck.

Prolonged Post Inflammatory hyperpigmentation 8 months post co2 laser - how can I improve this? (Photos)

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Prolonged Post Inflammatory hyperpigmentation 8 months post co2 laser - how can I improve this? (Photos)

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Everything you need to know about CO2 Laser

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