Suspect Melasma Caused By Laser Hair Removal

I am a 35 year old caucasian woman.  I had laser hair removal done with the final session in May 2010.  I avoided the sun last summer due to the fact that I was on a topical cream to treat a mild case of perioral dermatitis.  I have had significant sun exposure this year, and have developed a clearly defined area of dark pigmentation on my upperlip.  It basically looks like a hairless mustache.  There is no other blotchiness on my face at all.  I saw a dermatologist and his diagnosis was Melasma.  

I have a 40 year old friend with similar coloring (pretty fair complexion and curly, dark thick hair).  She had one laser hair removal treatment at the same spa which has resulted in the same defined dark discoloration on the upper lip after sun exposure.  I have read if the incorrect setting or laser type is used for a patient's skin tone and hair type it can cause hyperpigmentation.  I think this is supposed to be a temporary side effect; not long lasting.  I suspect the laser altered my skin in some way and predisposed me to this condition.  Am I completely off base?  

I tried to speak with my dermatologist about my suspicion.  He just stated I have Melasma and prescribed Hydroquinone.  He didn't seem to have the time or energy to get involved in any discussion.  I understand Dermatologists deal with serious ailments; maybe some don't have the patience for cosmetic concerns.  I can assure you this has caused significant stress on my part.  I haven't been myself since this discoloration began.  

I have been doing glycolic peels on my own weekly in addition to the Hydroquinone.  I do see some fading after about three peels and a week of the cream.  I have done my best to avoid the sun as well.  It's easier said then done when you have a five and seven year old.  I would like to figure out if my skin was permanently changed in some way or if this is (hopefully) transient Melasma.  I'm sure there is really no way of being certain.

The reason for my post is to see of any of the dermatologists who read these forums have come across another woman or man who seemed to develope melasma or hyperpigmentation due to laser hair removal.

[Bhupinder Kaur, MD]

Hello,
Although this site is common for melasma, yet since the hyperpigmentation appeared after the laser treatment. Hence it can be due to post inflammatory hyperpigmentation. Topical treatments with acids and chemical peels can be effective but can take a while for the skin to totally revert to its normal color.  Microdermabrasion can also be done, but this might require several sessions. Also use the hydroquinone cream with caution and as advised by your dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.