What Are Your Recommendations For Treating Post-Inflammatory Hyperpigmentation After Laser Resurfacing?
Q: I am suffering from some hyperpigmentation from Fractional CO2. I had a few courses of Medlite (At both 532 and 1064 wavelengths) but have noted little improvement. I am also using bleaching creams – hydroquinone and Retin-A. What in your practice has helped with laser induced PIH? I am Asian and probably have skin type III.
A: Post-inflammatory Hyperpigmentation (PIH) can be a sequelae of any form of facial laser resurfacing. However, it is most common in patients with intermediate skin pigments such as Asians. Once it occurs, it can be very difficult to treat. Bleaching creams, steroids, and Retin-A are common topical treatment methods. The use of combination hydroquinone and kojic acid creams are the best topical agents. Laser and light therapies that target brown pigment may also be helpful.
PIH is a particularly difficult problem in Asians. It is so problematic that I have evolved to the point in my practice that we simply don’t do laser resurfacing on patients of this ethnicity and skin type. (at least not deep laser resurfacing) Once it occurs, it is virtually impossible to get rid of it. It can be most disconcerting for those patients so affected. It appears that prevention is a far better approach than any post laser resurfacing therapy for Asian PIH.
Dr. Barry Eppley