I thought this site was for professionals to share information with each other, not a patient information site.

Monica,

What treatment did you have and when?

Monica, you are in the right place. Annie, where are patients supposed to go when they have had an adverse event. The laser companies don't care - see Lumenis Malcontents. Annie, we all learn when we help patients PLUS it is the right thing to do.

Monica, when did you have your treatments, how many did you have, what laser was used, what settings (if you can find out). Hopefully it was done recently because the redness will probably fade.

Give us more details and we can help you. Annie, you may learn something, so pay attention. If you are a doctor, your "two cents" would be appreciated.

First of all, I'd like to really thank the professionals for helping those of us who have experienced problems and side-effects from lasers. It is scary an upsetting when these types of problems unexpectantly occur and we don't know who to turn to or what to do next. We live in our skin and want it to look good which is why we go for laser treatments to begin with. I am very appreciative of the information and suggestions offered by the professionals on this site. Thank you, thank you , thank you again!!!!!

Hi again Dr. Joe

I think the hydroquinone is starting to help my marks fade slowly and slightly. I am noticing them a touch lighter. I am wondering if it would be ok, considering my circumstances of still having some brownish red marks, to get a Green Peel which is all natural and supposed to help with pigmentation?

Thanks!

Eva,

Probably ok, but you may want to let things settle down and not cause too much irritation. Slow and Steady and conservative for now. Have the peel in 6 weeks. Don't use too much hydroquinone (leave on too long or use too frequently). Slow and steady!

Just wanted to add that I had severe burns on my FACE from what I believe was light sheer several years ago. The dermatologist who caused the burns didn't even have the decency to return my calls. Needless to say, I never returned to her. I thought I was in fairly safe hands seeing a derm. in a major hospital, and it wasn't even my first or second appointment. I used hq which helped, but basically time is what it took. A good makeup consultation also helped until things cleared up. My complexion is completely clear now.

Hi "in Toronto". Wondering how long it took for your burns to clear up? What was the strength of your hydroquinone? Thanks.

Hi. I hope someone can help me out here. I used 4% hydroquinone cream to treat hyperpigmentation and now my face is red with irritation especially around the eyes and nose. What do I do to help it calm down. The skin looks very dry as well. I am not sure whether I should put some moisturiser.

You can use a mild hydrocortisone preparation to calm the skin down. Some people may have mild irritation reaction to HQ. If you cannot use HQ at all, you can get other bleaching formulations from your MD. HQ can also cause paradoxical hyperpigmentaton in rare cases. A lot of HQ products are compunded with AHA or vitamin A, so you may also be allergic/sensitive to these ingredients. Use everything sparingly and apply gently on the skin.

Hi. How many days rest should I give my face before using HQ again. The redness has lessened today without applying anything. I've been able to get some HQ cream without any other additves at a lower % so I can try this. Thanks.

As long as the redness setltles, you may resume use. Use every other day to prevent irritation.

Hi. My face hyperpigmented after a laser procedure. This was 4 months ago. I am currently using SPF30 as sunblock. I am also on 2% HQ cream used only at night. I need to make a one month trip to South India where the sun can get really hot. Is it alright to be out and about as long as I have sunblock on? What is the typical waiting period before you can go out in the sun? Any advise would be appreciated.

SN, use a physical blocker in addition to sunscreen. Use a hat and use zinc oxide.
Viky, when you use HQ or RetinA, start with every 3rd day for 2 weeks, then every other day for 2 weeks, then every day. If you still get irriation, don't use it all night, only use if for a few hours during the day or evening. You skin has to get used to it. It causes paradoxical PIH when it causes irritation (esp in darker skin types). Hope this helps.

Hi Doctor. I have switched to a lower 2% HQ cream with no additives. I put this on before I go to sleep. There does not seem to be any irritation for the past 3 days. This morning however, I notice the skin under my eyes and near the bridge of my nose is slightly darker. Is this what you mean by paradoxical PIH? The skin there is just dark not irritated or red. Do I just need to give my skin sometime to get used to HQ?

Hi Doctor. My skin around the under eyes is slightly red from using the 2% HQ. I didn't think such a low % would also cause redness. I do feel that it does seem darker than the night before when I wake up. I will do as you suggested - gradual increase in usage. I just want to know that should I just leave it alone and just put an under eye cream, will it eventually go away or is this permanent?

"start with every 3rd day for 2 weeks, then every other day for 2 weeks, then every day. If you still get irriation, don't use it all night, only use if for a few hours during the day or evening. You skin has to get used to it. It causes paradoxical PIH when it causes irritation (esp in darker skin types). Hope this helps."

Viky, use it less often or have it on for less time per day. I would not use it for a while (a week or a few weeks and then start slowly, very slowly).

You should get NO REDNESS or irritation. If you are getting redness and darkening, you are using TOO much TOO frequently for TOO long!

You may want to switch to Kojic acid or Arbutin or something without Hydroquinone.

Hi Jee. Thanks but as I asked earlier, if I were to stop everything and just use an eye cream and moisturiser, will the hyperpigmentation eventually go away and my skin return to normal or this a permanent thing? The PIH was from a laser a few months back. Thanks.

Dear Dr. Thanks for writing back, sorry it took me sooo long to get back with more info. My name is MONICA and wrote to you on 12/10. I had the Erbium laser on dec 01/08 for my very thin shallow white strech marks due to weight lifting. They do not want to tell me what was the intensity they used on it, and do not return my calls. The are around my glutes has definetely faded. The area arond my hips (it looks like brown /red strech marks) is not really fading fast. I have used HQ, which I discontinued cause make my skin more red and I was in panic...I am using mederma and some cocoa butter and something called Mother of pearl cream (sold here in my country Ecuador). I am hispanic, with very light skin and dark hair. Don´t know if this will fade, I have a fitness competition in april and a vacation to the south pacific also in april for my 10 year wed. anniversary...I would love to send you my progress pictures, but where to?...THANK YOU SO VERY MUCH....MONICA

Viky,

The pigmentation issues will most likely go away if you stop the HQ. Most of the time the PIH will go away in 3 to 6 months. The HQ does tend to help with PIH and speed up the process.

The comments made by JEE are probably your best bet.

Hello everyone,

I am a very light african-american woman. I also have chinese , dutch and native american ancestry.
Seven months ago (May '08), I had some slightly raised dark moles on my stomach removed via a CO2 laser. I think there is another name for the "moles," but I've always thought of them as bumpy moles. My stomach is now very smooth, but I experienced hyperpigmentation around minor scar sites where some of the moles were. I don't have a problem with the minor scars. According to my doctor, over 200 "moles" were removed. Of course, I expected some scarring. However, the hyperpigmentation around the scars bothers me as I didn't realize it could occur. I don't know what laser setting was used, etc. Anyway, does anyone have any ideas about how to reduce the hyperpigmentation?

Monica, contact me "off line" at Jeff4459@aol.com and I will let you know how you can post the pictures.

Lisa, you could try a. just give it time; b. Hydroquinone and RetinA; c. IPL with 590 nm filter. Probably best bet is just to let it fade over time.

Hi Dr. Joe

I wrote you a few times - just letting you know, I had a chemical peel 2 weeks ago- the spots on my cheeks may be slightly lighter but they are still there. When I look very close - they are more pinkish than brown - almost see tiny tiny blood vesswels maybe making up the marks - could that mean it is vascular? And what should I do next? I am seeing the doctor to take a look at my post peel results in 2 days so I will ask her as well. It has now been 4 months since the laser and 2 weeks since the peel. I'm kind of doubting that HQ is going to help it anymore.

Thanks!!!

I agree with some earlier posts on this thread - persisting PIH responds very well to one or both of:
- Q-switched 1064 laser, eg Medlight C6 at fluences of 6.5-8.5J - just enough to give an epidermal reaction/frost
- Fraxel - a course of 3 -5 treatments at lowish fluences eg, 15 - 20 mJ and density level 8 - 9
- combined with bleaching agents, eg, H4%, Kojic4%, Tretinoin 0.01%-0.05%
- strict UV avoidance

I saw the doctor today who is treating my spots. She put me in for IPL next week to try and get rid of the redness that is creating the marks. Do you think that is a good idea?

hi, am african but i have very light skin almost like white , i used to have acne marks and i corrected them by using bleaching creams, but now i have hyperpigmentation and my face turn completelly dark idid use creams with 2%hydroquinone but now hq is banned in europe i want to know what should i do ??please help

by the my face is very dry and the texture of the skin changed this only around my face but down my chin my skin is okay.I was wondering if I go to see dermatologist will they be able to correct it by HQ with higher % or i should do skin peel?!but I am also scared about skin peels as many people said its cause more pigmentation.I am 31years old.

iahve this problem for almost 18 months now and my face turns darker and darker.any advise will be appreciated.thank you

Eva, if the problem is vascular, you need a vascular treatment. IPL, Long Pulse 1064, Pulse Dye or KTP Laser would be good. Melasma sometimes has a vascular component.

Ok, thanks. I find this doctor to be quite good so far so I am hoping this will help. I'll let you know how things go.

Hi again Dr Joe

Ok - so I had the IPL on the spots on my cheeks one week ago. So far not much change at all - if anything they maybe look a touch darker. As far as I understand, it could take a few weeks to lighten - does that sound right?

The dr. has me booked for another visit in 3 weeks to treat the spots again with her Medlight laser. She said the IPL was to target the redness and the following visit will target the browness.

I'm just getting irritated because I'm not seeing anything after the IPL but is that normal not to see any results or lightening yet?

Thanks!

...So, it's been almost 3 weeks since the IPL on the spots - the redness may be slightly reduced but areas look darker (brownish grey). Is that good or bad? Normal?

The next step is I'm goin back in 2 weeks for the Medlite C6 treatment. Do you still think this is a good idea? I really don't want things to get worse!!

She also prescribed me Retin A which I am using every few nights.

Thanks!

I concur completely with dexter. I have been pre-treating patients for the past 10 years with a compounded 6% HQ, 0.05% Retin-A, and a 0.1% hyrocortizone formulation. I have Type IV's and above use the compound for 10 days pre-treatment, stop 3 days before., do the treatment, wait for 3 days, then use the compound for an additional 10 days post treatment. There has been little to no PIH with our patients, and I feel this is due to the suppression of the melanocyte activity PRE-treatment as opposed to trying to chase it POST-treatment. I have my Laser Hair Removal patients use this, my IPL patients, Skin tightening, Fraxel, anyone and anytime there is bound to be heat trauma to the skin.

I concur completely with dexter. I have been pre-treating patients for the past 10 years with a compounded 6% HQ, 0.05% Retin-A, and a 0.1% hyrocortizone formulation. I have Type IV's and above use the compound for 10 days pre-treatment, stop 3 days before., do the treatment, wait for 3 days, then use the compound for an additional 10 days post treatment. There has been little to no PIH with our patients, and I feel this is due to the suppression of the melanocyte activity PRE-treatment as opposed to trying to chase it POST-treatment. I have my Laser Hair Removal patients use this, my IPL patients, Skin tightening, Fraxel, anyone and anytime there is bound to be heat trauma to the skin.

Over the past year and a half I have had 3 full face ipl (fotofacial) treatments for sunspots and freckles. I am a female caucasian with pale white skin that burns easily and freckles easily too.The first 2 times I had good results. Though I had a few hyperpigmentation spots on my forehead and chin. But the last time I had it done., which was 6 months ago now,I got 2 burns on my face,

Now my face has white scar like spots (small and round)on it in at least 10 different spots. Are these scars and will they go away? And if they are scars what should I do? And also what would you suggest I do for the hyperpigmentation? Thank you so much for taking the time to read this. : )

Missy from Vancouver

Sorry my above post is for Dr Joe or Dr Wang. Thank you.

Doctors:

Any experience with chemical peels? I had the vi peel done a few months back and had some good results - helped the pigmentation slightly. I had the peel done professionally which seemed quite simple so I ordered another one and did it myself last night and this time I got the precision applicatior which has a small amount of the solution that is even stronger to use on scars and pigment. All the areas that I used that on went extremely dark red to almost purple. I know spots tend to go darker but it's freaking me out? Any comments or suggestions? I won't know what it'll look like underneath for a few days now until that peels off.

Hi Doctors. It's been 8 months since I did the laser on my face. My facial tone has improved tremendously however, my under eyes are still dark - the skin there is brownish grey, shiny and flat. I understand that if it's PIH it would have faded by now. Is this scarring? If it is, is there any treatment to correct it? Is this permanent? Any advise would be appreciated. Thanks.

Hi Dr Joe
I had the fraxel co2 re:pair laser treatment 6months ago and now have post inflammatory hyperpigmentation all over my face.Is this permanant? I am currently being treated with 4%hydroquinone with little effect? Any ideas about what I should do?.
Thanks

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white stretch marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the Dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days it crusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% Hidroquinon or Obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or Obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

Help! I had Fraxel laser done 2 years ago and have one large brown spot on each cheek . I tried cosmalon mask and it worked for about 4 months and when i went back on the pill the spots got darker. I also have tried hydroquinone for about 4 months and stopped because i read that your skin can thin from using it. I have med to light skin color and my backround is cuban, German ,Pourterican, I have been off the pill for about a year and the spots have gotten lighter but they still bother me.What can i try ? Jeannette

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

I am soooo desperate Doctor, crying as I write this post. I had a very nice body and due to mild weight lifting, few very thin almost unnoticeable white strech marks....as all fitness pros, we try so seek perfection and there is when we play with fire...the dr. told me he could help and diminish the appearance of this mild lines by 40 % with laser....he did it and the first days it was fire red, the after 6-8 days itcrusted and started to peel...then it peeled and a pink color on the strech mark stie is very noticeable not...i am desperate....he prescribed 4% hidroquinona or obagi regime if the first does not work...i am so depressed do not even want to go out...I am a bikini model so you can imagine how I feel...i just want to go back to my old self....these new red/pick lines are so obvious and shinny....please help

Heloo doctor,

I had done my first IPL 3wks back on my face and neck for seborrhic keratosis.(this is the diagnosis my dermatologist gave)I am india ,30 yrs old female.
While doing the procedure it was hurting most of the time,my doc said that was usual. I had severe red marks over my forehead and neck.I was given hydro cortisone cream to apply just for that day,and put some ice pack..over the next few days,those red areas were healing like a bruise and slowly turned into tan ,brown marks( on forehead and neck).
I am not sure if its burn or hyper pigmentation.my keratosis have cleared.
I am just giving it time to heal by itself.just using sunblock.do light scrubbing at home and moisturize my skin.
Doctor,do you think I should use any other product or will it fade off by itself? how long it would take to get back to my normal skin.
I definetly regret for doing IPL. please helllpppppppp me!!!!!!!!