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Skin Type: Pigment & Complexion > Post IPL hypopigmentation

I did an IPL treatment on a patient 10 days ago for hyperpigmentation (skin type 4) . The settings were as recommended but the patient developed blisters and scab 2 days afterwards. I think that he went out into the sun. Now he has large hypopigmented areas in the shape of the handpiece. I know that we have to wait and observe. Does anyone know what are the chances of melanocytes/pigmentation coming back into the areas and what Is the average wait? I feel hopeless that It will ever come back. Does elidel work in bringing pigment back? I would apprreciate any advise.

06.30 | Registered CommenterDr. FrankT

Unfortunately hypopigmentation is a permanent condition, while hyperpigmentation caused by lasers will go away with time. Unfortunately for you and the patient this is a permanent spot.

06.30 | Unregistered CommenterAE

Just wondering, what device were you using?

06.30 | Unregistered CommenterAE

A few comments. First off, when you treat type 4 patients with IPL you better know what you are doing. The scabs and blisters are not from them going out in the sun after the treatment. You over treated this patient. It's probably not permanent hypopigmentation though. The pigment should come back over time, but it will be awhile.

06.30 | Unregistered CommenterSpeed Pass

I agree with SpeedPass.

07.1 | Unregistered CommenterLH

Do not treat type IV or V skin unless you have accumulated a lot of laser nd IPL experience on darker skin types. You have to lower the fluence and watch the end-point very carefully. Personally, I do not think IPL is good for darker type IV or type V skin in general. Do not treat melasma in Type IV and V with IPL unless you absolutely know what you are doing.

07.5 | Unregistered CommenterCanMD

Type iv / asian / hispanic skin types are very tricky when using IPL. This is the reason I seldom use IPL on them. I mostly use low powered yag laser or KTP. Hyper is something we can treat using 4% HQ, but hypo is something we will have to wait and see. For the time being, lots of suncreeen, and vitamin c serum seems to help a little.

07.5 | Unregistered Commenterc.lee

all my patients are type IV and V.
I use lumenis one , for 1st sessions , better use lower fluence then preset . Usually if preset is 17J,better start with 12J for test spots.
1 case of hypo , gone after 3 month.

I have had some varying degree of success using a fraxel / Lux 1540 for hypo pigmented areas.

Thanks for all of the great recommendations. I used the Natural light IPL machine. I saw the patient back today and amazingly the hypopigmentation resolved completely in only 3 weeks! I definetely need more IPL experience so this never happens again. I am not going to treat type 4 anymore.

07.18 | Unregistered CommenterDr.FrankT

Thanks for the great recomendations. I will definately look into this!!!

07.22 | Unregistered CommenterTom

I did an IPL treatment on a patient 10 days ago for hyperpigmentation (skin type 4) . The settings were as recommended but the patient developed blisters and scab 2 days afterwards. I think that he went out into the sun. Now he has large hypopigmented areas in the shape of the handpiece. I know that we have to wait and observe. Does anyone know what are the chances of melanocytes/pigmentation coming back into the areas and what Is the average wait? I feel hopeless that It will ever come back. Does elidel work in bringing pigment back? I would apprreciate any advise.

10.11 | Unregistered CommenterDr. FrankT

I did an IPL treatment on a patient 10 days ago for hyperpigmentation (skin type 4) . The settings were as recommended but the patient developed blisters and scab 2 days afterwards. I think that he went out into the sun. Now he has large hypopigmented areas in the shape of the handpiece. I know that we have to wait and observe. Does anyone know what are the chances of melanocytes/pigmentation coming back into the areas and what Is the average wait? I feel hopeless that It will ever come back. Does elidel work in bringing pigment back? I would apprreciate any advise.

10.20 | Unregistered CommenterDr. FrankT

I did an IPL treatment on a patient 10 days ago for hyperpigmentation (skin type 4) . The settings were as recommended but the patient developed blisters and scab 2 days afterwards. I think that he went out into the sun. Now he has large hypopigmented areas in the shape of the handpiece. I know that we have to wait and observe. Does anyone know what are the chances of melanocytes/pigmentation coming back into the areas and what Is the average wait? I feel hopeless that It will ever come back. Does elidel work in bringing pigment back? I would apprreciate any advise.

12.22 | Unregistered CommenterDr. FrankT

Thank you very much for this useful article. I like it.
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01.27 | Unregistered CommenterSin

my experienced , just dont anything ..and the pigment will comeback around 6months to 12 months. ( cross your finger)
in the meantime .. just have to use the cosmetic for coverup

01.27 | Unregistered CommenterDr Shah

my experienced , just dont anything ..and the pigment will comeback around 6months to 12 months. ( cross your finger)
in the meantime .. just have to use the cosmetic for coverup

02.2 | Unregistered CommenterDr Shah

my experienced , just dont anything ..and the pigment will comeback around 6months to 12 months. ( cross your finger)
in the meantime .. just have to use the cosmetic for coverup

03.15 | Unregistered CommenterDr Shah

my experienced , just dont anything ..and the pigment will comeback around 6months to 12 months. ( cross your finger)
in the meantime .. just have to use the cosmetic for coverup

04.1 | Unregistered CommenterDr Shah

i am type IV, I got many hyperpigmentation, they do fade with time, but few stayed a bit even after a year. Hopefully in 1 more year they will fade completely. I have a personal chinese machine. I don't blame the machine. I put the settings high, but now I found that increasing RF to 15 energy and setting IPL to 18 energy, does the trick, the hair falls off nicely after 10 days. so if you got the option to put RF+IPL thats it just dont need to put more than 20 energy for IPL, increase the RF energy instead.

One suggestion, usually you will find the skin burns when you do the very first pulse, so keep the handle away from the skin the first pulse, and then u contact with the skin the second pulse. IT REALLY WORKS ;)

10.24 | Unregistered Commenterwayz

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