I Am 7 Weeks Post Op for Co2 Laser Removal of a Sebaceous Hyperplasia Under my Right Eye. The settings of the laser were 1 pass, 4 watts P22. It was bright red 2 weeks ago and is now a darker red. My PS said it is not hyperpigmentation. I have used aquaphor, hydrocortisone 1%, hydrocortisone 2.5%, cutivate .05% and a pack of oral steriods. My PS will not prescribe Group 1 or Group 2 topical steroids due to thinning of the skin. His ARNP stated today that it will clear up with "time." I am not seeing much progress at 7 weeks and would like to know your opinion regarding this.
Hyperpigmentation 7 Weeks After CO2 Laser Removal of Sebaceous Hyperplasia
Doctor Answers 6
Hyperpigmentation of the face after laser
Raffy Karamanoukian MD FACS
Hyperpigmentation of the face after laser resurfacing requires treatment with several product types
There is definitey hyperpigmentation following your procedure and proper care with products that are hydroquinone based and non-HQ based can help reduce this effect. I recommend Melarase AM and Melarase PM as well as protection from sun damage using Spectrase. Proper hydration and deep moisturization is also an essential component for the healing process (Elevase).
Scler-X is a post inflammatory hyperpigmentation relief complex that I also recommend.
Hyperpigmentation After Co2 Laser Resurfacing
Treatments for PIH that can be helpful are topical steorids, vitamin A derived skin care products (Tretinoin), and Hydroquinone. All these are included in a cream called Tri-Luma, which is my preferred topical for PIH. One can prescribe these creams in various concentrations and formulations individually as well.
Beyond topical agents and time, the other two treatments I have seen helpful are the use of pulse dye lasers and various types of Q-Switched lasers, the type that are used in tatoo removal. Here the physician experience and technology availability are very important.
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EpiQuin Micro for post-CO2 pigmentation
I like to use a high quality hydroquinone in follow-up after CO2 to prevent dyspigmentation. I do appreciate the benefits of erbium lasers for cutting with less heat in treating things like sebaceous hyperplasia. Still, when you want skin tightening Fractionated CO2 is the best we have. I think you will get away fine with time and I don't believe high potency steroids will benefit the pigmentation at this point. Adding a high quality hydroquinone such as EpiQuin micro or Lustra may be beneficial. Good luck.
IPL for post laser redness
Dear laser patient from Florida,
From your photo this appear to be inflammatory and usually will resolve with time as redness and inflammatory reactions are usually not permanent after this type of procedure. You may want to inquire about an intense pulsed light treatment that may take the redness out. Best of Luck