What are the best treatment for hypopigmentation?

Question

I had laser skin resurfacing years ago and my face is very pale due to hypopigmentation. What are the best treatments to bring back some color to my face?

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an Aesthetic nurse at Aesthetic skin in Chicago.  That’s a really important — and very delicate — question. Post-laser hypopigmentation (loss of pigment) can be one of the hardest complications to treat, but there are approaches that can help stimulate some re pigmentation or at least make color more even and natural-looking.  Microneedling + topical pigment stimulants Gentle microneedling creates microchannels that help delivery of melanocyte-stimulating peptides, growth factors, or even your own PRP (platelet-rich plasma). Some case reports show mild repigmentation when combined with nb-UVB or topical tacrolimus.
Important: must be done cautiously and only by an experienced provider to avoid further pigment change.

Anna Chacon, MD, FAAD · Answer

I hear how frustrating this must feel for you, when your skin loses pigment, especially after a procedure, it can really affect how you feel about your appearance. Hypopigmentation after laser resurfacing can be one of the trickier things to treat, but there are definitely options that may help bring back some balance and color to your skin.

Sometimes, treatments that stimulate melanocytes (the pigment-producing cells) can help, such as excimer laser therapy, microneedling, or even targeted phototherapy. In certain cases, topical medications like tacrolimus or other pigment-stimulating creams may also encourage some repigmentation.

That being said, results can vary, and hypopigmentation is often more challenging to fully correct than hyperpigmentation. Some people also explore cosmetic options like skin camouflage or light self-tanners to help even things out while working on longer-term solutions.

The most important part is tailoring the treatment to your skin type and history — what works for one person might not for another. With the right approach, we can usually find a way to make the contrast less noticeable and restore more harmony to the skin’s tone.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

What are the best treatment for hypopigmentation?

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