Hyperpigmentation after Laser / IPL

Hi!
I had a series of IPL treatments a couple years ago with great results. I did it primarily for general redness. I also had two very small, light (smaller than a pencil eraser) sun spots completely vanish. It was great. I’m pretty fair skinned and didn’t have a lot of pigmentation issues, but was happy to see those two spots on the side of my face disappear. My skin is a bit sensitive, so I was scared going in, but it was better than I’d hoped.

The IPL didn’t alleviate one stubborn blood vessel, so a friend suggested I go see the plastic surgeon she and her mother had gone to for some laser treatments. I went in for a consultation, and he noticed a scar on my forehead from a childhood injury. He said he wanted to treat the scar with the Pixel laser, then go over the rest of my face with the pixel to help with “residual redness.” He then wanted to do one IPL treatment (at the same visit).

I saw some before and afters, and my friend and her mom had gone to him, so I agreed to the treatment.

He did the pixel, and it hurt so bad I tried to get up and leave. It was 2-3 times more painful than the IPLs I had had. The nurses were literally holding me down; they kept telling me it was “almost over.” When he finished, I tried to get up, and they said I needed to let him complete the treatment with the IPL or it would all have been for nothing. He did the IPL on half my face. He stopped when I started shaking.

I swelled up like a balloon, got red, oozy and scabby and looked like I had been hit by a truck. My eyes were swollen shut. It was two weeks before I could leave the house.

When my face finally healed, I had a large area of hyperpigmentation on my left cheek. The scar on my forehead is a big, blotchy mess as well. The doctor told me it must be because I am “prone to hyperpigmentation” and that the “IPL might have caused it.” When I reminded him that I had had IPL in the past with no problems, he blamed the pixel.

The past is gone, and now I want to try hydroquinone to fade the darkness, but I’m not sure it will work on this type of pigmentation. I also keep reading that it’s dangerous and can make things worse. Will it? What’s the best approach?

I’m sorry this is so long; thank you in advance for any help you can offer.

hi
oh man!
what an experience. i’m sorry you had to go through that!
i do not think that hydroquinone is dangerous at all.
i would try that first at an 8% strength. we have that kind of cream compounded for us and it quite inexpensive. if you want it shipped out, i’ll be happy to do so.
if that doesn’t work, you can try Vi peel – we have had good results with that as well for hyperpigmentation. the other thing to remember is to not let sun get on your face – it can make the pigmentation worse. be sure to use a 30 or higher spf with zinc or titanium.
hope that helps

Posted in IPL, Uncategorized | No Comments »

Rosacea, Fine Lines and Skin Tightening

Hi, I’m 45 years old, the clinic I go to has recommended 3 treatments because I have complained about slight rosacea, vertical lines on cheeks and above lip and some loose skin on the lower sides of my cheeks and chin………………
the machine they use is called Fractional Non-Ablative Skin Resurfacing with the Palomar Starlux System, the treatments are $900.00 a piece.
Would this help these problems, is it worth the expense….Would 3 treatments do it?
Thanks so much.

Although I don’t have this device, I do have the Starlux. I have been happy with the Fraxel Fractional Laser, however, I am somewhat skeptical that a fractional device will help you with rosacea and skin tightening. Honestly, I have a hard enough time seeing good results with Thermage (whose very purpose is skin tightening!). I simply don’t think that this device will do all three things. It’s an Erbium laser, which is good for helping the fine lines a bit, but I don’t think that it’s powerful enough to make that much of a difference. In my opinion, IPL/photofacial would be a better modality for your rosacea.

Make sure that you speak to a doctor at the clinic – if you’re going to shell out that kind of money, you want an MD telling you that yes, this is the right procedure for you.

For the best results, I would target treatments, offering IPL for the rosacea, Thermage for the skin tightening and Juvederm for the lines. Sometimes one size does not fit all!

Posted in Fraxel, IPL, Juvederm, Rosacea, Starlux, lasers, photofacial, thermage, wrinkles | No Comments »

Chest Sun Damage and IPL vs Peels vs Active Fx

Hi Dr. Rivkin,
I have sun damage on my chest from years of sunbathing when I was young – which I no longer do.
I also have flat white acne scars in the same area, which show up even more due to the darkness of the skin caused by sun damage.
I had one IPL treatment but did not notice even a slight improvement and it was around 500.00 to have it done.
I was told by the woman who gave me the treatment in my dermatologist’s office that microderm would work just as well.
I have always been self conscious about my scars, and feel like there has to be something that will be effective on them and the sun damage.
Can you look at my album photos and advise me on the best procedure and how many I will need? Also, the estimated cost if possible.
Thank you,
Pamela

Hi Pamela,
I do not think that microdermabrasion will do much, but it certainly will not hurt and it may help over time.

There are some decent chemical peels out that may work – Vi peel is something we’ve been doing in the office – seems to give good results so far. It’s pretty cheap – $300 or so some of the more aggressive lasers may help with the hypopigmentation – active fx is a good one. there is some downtime with these lasers, however. its expensive – about $1000 or more.

Another option is to try the IPL again on higher settings, making sure that you are not suntanned at all prior to treatment. you can pre-treat with a hydroquinone cream for 2 weeks and that should let your doc use higher settings.

http://www.westsidemedicalspa.com/IPL_photofacial.html
http://www.westsidemedicalspa.com/activefxlaser.html

Posted in IPL, hydroquinone, hypopigmentation, lasers, microdermabrasion | 1 Comment »

Red after Chemical Peel and Blepharoplasty Question

I have had 4 deep chemical peels done to remove severe acne scarring over the past 7 years. After the last one my skin has stayed bright red. It has been almost a year now and it is not fading. I now have to always use a moisturizer with a green tint and thick waterproof makeup in order to cover it up and it still looks red in pictures. I won’t even let my husband see me without makeup. I am scared to go swimming with my kids because the makeup might wash off. I had the chemical peels so I wouldn’t have to wear so much makeup. What would be the best treatment to get rid of the red?

Also I am 37 and have droopy upper eyelids, they almost rest on my upper lashes. The are not crepey but just a fold. Is there something I could do other than eye surgery?

That’s a long time to be red! You should not have to suffer through this without help.

I would go to your dermatologist and ask their advice about the redness. IPL photofacial or YAG laser treatment would be a good idea for you. You will probably need several treatments, but it is worth it.

By the way, you may want to speak to the office that did your last peel. This is a problem that they had a hand in causing, so they may want to take some responsibility in fixing it.

In terms of your eyes, I do not think that you are going to get away from having a blepharoplasty (eyelid surgery) – there’s no way to tighten that skin non-surgically. The good news is that it sounds like you have an issue that insurance may cover: when the skin folds over so much that it interferes with vision, medical insurance will cover the procedure. I would speak with an oculoplastic specialist.
Hope that helps.

Posted in IPL, YAG, acne, acne scarring, chemical peel, eyelid surgery, lasers | No Comments »