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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.
12 Responses
563773 tn?1374250139
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.

Avatar universal
I have had the very same experience--a hyperpigmented upper lip as a direct result of laser hair removal (I had IPL). I had originally gone to the laser clinic to treat two small sunspots--one on either cheek, which honestly, never really even bothered me that much but that I thought might clear up a bit with some IPL treatment. (When I think back on how little research I did at the time, I am horrified.) While I was receiving one of the treatments, the technician suggested I also consider IPL for hair removal on my lip and chin, which I subsequently did at the same location--six to eight sessions over the course of several months. I was told I was the perfect candidate because of my dark hair and my "light" (but olive) complexion. I consider doing this one of the worst mistakes of my life.

About a year after the treatment (i.e. one summer later), I started noticing a "tan" on my upper lip. Slowly but surely, it dawned on me that it wasn't a tan but rather a darkened upper lip in the exact area of laser treatment. (The area also tingled slightly in the direct sun and on very hot days, even when I was not in the sun. This clued me in to the fact that whatever it was was very different than the small sun spots on my cheeks.) Every year, this hyperpigmentation has gotten darker. It seems to get darker no matter what I do and no matter how obsessed I am with keeping it covered and use sun screens with high zinc oxide percentages. (I used to love the sun and was, although consistent about sunscreen, a really summer and sun lover; now I am so paranoid about the sun that I actually hate to leave the house on hazy bright days because I know the rays are going directly to my lip, which seems to "attract" the sun more than any other place on my face, sunscreened or not.)

Needless to say, I am devastated. It has been 6 years since this happened, and I still think about my lip and regret my decision to do IPL every single day. (Every time I go to the restroom and look in a mirror, every time I do my makeup, every time I feel someone glancing at my lip while speaking to me, every time I feel hot or notice the sun hitting my face, I think about it.) As a result, I have spent a lot of time online trying to research this and find other people who have experienced the same. (Of course before the procedure, all the online reviews I read raved about the results--there is SO much propaganda out there selling this as a miracle fix! The dangers of any laser hair procedure are vastly understated--if you can find them at all, and it's only after this has happened to me that I have searched harder and harder and finally found others with similar results.) In fact, the best--most scientific yet completely accessible explanation I have found says this:

"Melanin is the natural chromophore (light-absorbing molecule) for targeting hair follicles..., [but] melanin in the epidermis presents a competing site for absorption. In persons with darker skin, the higher levels of melanin in heavily pigmented skin (tanned, Asian, Blacks, etc) compete as a chromophore for the laser light. This light is converted to heat and can cause...changes in skin pigmentation." (I got this from a blog post that actually has a great explanation of all of the different hair removal procedures and their risks. Scroll down this post, and you will see it: http://rlbatesmd.blogspot.com/2008/02/permanent-hair-removal.html)

I have an olive complexion--although I wouldn't call it dark, in fact, in the winter, it seems even a bit light (though still olive), I know that this is exactly what happened to me. (I always tanned well, so it seems logical that that my melanocytes would also be activated by the pulsed light/laser.) Unfortunately, based on this explanation, I don't think there is anything to be done about this darkened skin. There is no way I am going to try any other laser procedure, and now I am even hesitant to try any prescription creams because of the possibility of making it worse. (Sadly, I believe that hyperpigmented skin is permanent. Like freckles or sunspots, once such a hyperpigmented "splotch" appears, it does not go away.) All of those lightening creams and prescriptions do nothing, and the people who claim that the hyperpigmentation resulting from IPL/laser is temporary are full of it. I have read more testamonies that convince me of this every time I look online.

I am doing my best to accept this and to accept the fact that I did something to myself in the name of beauty that I thoroughly regret. It's not easy.

Best wishes to you.

Avatar universal
Wow, I feel like I just read about my exact experience. All this time I thought I was suffering from melasma, but your explanation above makes perfect sense. I know you posted your comment last year, but have you had any success with treatment? I unfortunately like the sun too much and have a difficult time avoiding it especially in the summer. I do use sunscreen regularly but as you already stated, it does not really help much. Thanks for sharing your experience and shedding some light on this subject. I have always believed that those laser treatments I had were connected to this issue...
Avatar universal
I have had the same experience.  I got laser hair removal done around 7 years ago.  I did it for my half arm and under arm.  The treatments were going great until around my fourth session. It was a painful session and once I got out, I realized that my underarm turn black. I went back to the place and they said that some people's underarm is darker; however, I am mixed, and my underarm was the lightest part of my body.  I figured it will go away and it still hasn't.  I had one more treatment after that and stopped.  My package is still not completed.  I figured it was my under arm and people do not look at it. But it is still bothering me.
Avatar universal
I've experienced exactly the same thing following my laser hair removal treatment back in early 2010. I now have unsightly brown marks on my upper lip which seems to get worse each year despite the fact that I use a high factor sunscreen on the area. I am considering having an acid peel on the area this winter but need to carry out more research.

The most irritating thing of all is that the hair on my upper lip has grown back, so not only do I have to deal with the problem I had pre-laser hair removal, I now have a moustache tattooed onto my upper lip. I'd advise everyone to steer clear of laser hair removal on the upper lip. I have very pale skin and was informed that I was a perfect candidate for laser hair removal on the face; however, the skin on the upper lip is far too sensitive for laser hair removal, whatever your skin tone.

I have spent a fortune on creams such as Clinique's dark spot corrector with little effect. The issue is that the damage caused by the laser is so deep no topical solution is effective.

I fear that the hyperpigmention will worsen over time, which terrifies me as the situation is already distressing enough.

Avatar universal
Unfortunately, I have found nothing that lightens or removes the darker spots. I just don't think this is possible, either. The only thing that has helped me keep things from getting worse is a sunscreen called La Roche Posay (find it on Amazon. Get the one with an ingredient called ”meroxyl” in it). It really does prevent darkening better than any other sunscreen I have found--even high factor ones from other brands do nothing for me. It is s bit white, so I cover it with a mineral powder after applying. Of course, I hate having to cover my face so much, but if I don't wear it, I feel so anxious about being in the sun that I can't enjoy myself anyway. Summer has really become stressful for me.
Avatar universal
Oh, and yes, just like veryve says, my lip hair has also grown back! It may be slightly sparser in places, but it's pretty much the same as it used to be. The laser clinics always promote laser hair removal as permanent, but what you learn if you press someone on the matter is that it's not permanent removal, it's permanent ”reduction.” Meaning that even the clinics know that some or most hairs will grow back. And yes, I don't think it matters whether your skin is dark or light. If the lasers target melanin/pigment in the hair, then the same laser ends up targeting the melanin in the skin! How could it not? How could the laser possibly differentiate between the two? What happens is that as the melanin in the hair is targeted and transferred to heat, it ”zaps” and kills the hair from the follicle. But when the same laser is also absorbed by the melanin in the skin, it turns the surrounding skin darker. (They place the laser right on the skin to get the hair, so I have no idea how they can claim the skin woykd not be affected.) Of course, you sign a waiver before doing it, so all of this is just hindsight talking.
Avatar universal
I'm so sorry to hear what happened to you all. I too have an hyperpigmented upper lip, but mine is due to excessive plucking over the years and not wearing sunscreen. I have PCOS which causes extra hair growth so I plucked the area more frequently than others. My derm advised me to seek laser hair removal, but now I am worried that laser hair removal will just make matters worse, which I just cannot handle. He said that laser hair removal is superior to electrolysis, but stories like this tell otherwise.

I read that IPL damages darker skin tones because it does not do a good job in differentiating melanin in hair follicles and melanin in skin, so it damages the surrounding skin.

Did all of you ladies have IPL performed on your skin? I am wondering if that is the main reason for the skin discoloration.

Again, I am so sorry to hear about this, and appreciate you all posting your stories. You may have saved me and many others from further hyperpigmentation.
Avatar universal
Unfortunately, it is my understanding that any depilatory method may cause hyperpigmentation on the upper lip. This includes waxing, plucking, threading, electrolysis, and lasers (all kinds, including IPL). It is simply delicate skin, and with any inflammation can cause PIH (post-inflammatory hyperpigmentation). In the case of lasers, heat activates the melanin. In the case of the other methods, the physical damage to the area results in similar darkening (as you know from tweezing). I honestly do not know how derms can recommend laser to correct pigmentation when it actually often causes it in the first place! Do yourself a favor and don't do it. It's a costly method, and it will not improve the situation. It could even make it worse. I know I will never try any other laser treatment. I wish I had just accepted my hair!
Avatar universal
Avatar universal
I too have had the same hyper-pigmentation issue after having laser done on my upper lip. However, it does go away during the winter but the moment the sun comes out it appears again. I have been trying to investigate if electrolysis has the same after effect as well? I really need to have other areas of my face done and am torn as to what treatment I can do! Do you have any thoughts on this? Thank you!
Avatar universal
I have never had laser hair removal on my upper lip. In my 20s I've shave my upper lip with a razor and now I have melasma 3 years ago. Everything I have read here really touches me because it sounds exactly how am suffering. I've tried doing tons of researched and bought everything everyone pretty much rave on. And like anyone else still suffering. I'm at my last resort, I'm doing thru dual yellow laser treatment from Norseld. This is a light purse laser procedure promise to zap the roots of the VEGF where all your pigment develop. I'm on my third treatment and received about 25% improvement. Dr recommended 4% HQ in conjunction. I've noticed I am getting scars, indented scar from multiple topical of ((retin a, i apply once and my skin shed))vitamin c, HQ, and all those other natural acid I've used in the passed. My skin now at a stage where its extremely sensitive and I fear that indented scar will be something I will suffer after melasma treatment and that's not even a promising of how effective this laser will be. I'm worried if its even worth it anymore. I've spend a lot of money to pretty much damage my skin. I'm trying to think positive and look for a way of recovery the damage tissue on my skin. I don't know if I should go thru the fourth treatment at this point.

I came across Dr John Wu MD website/ YouTube on Naimion.com he's articles and reviews is pretty much base on skincare. He's been helping patient who suffering from LASER/IPL SKIN DAMAGE. He himself suffered from severe acne. I'm not trying to sell anything nor I work with him. But I read everything he wrote and everything seem to make so much sense to me. The Dr who I'm seeing for my laser treatment don't recommend obagi or HQ but he put me on HQ in conjunction of the procedure?! I've been to 3 dermatologist and they all just want to sell me there expensive skincare and treatments all estimate cost of over $2,000! When you read their advertising they promise you there's a solution. But once you go in for consultation they give you 50/50 hope and break your wallet on a 0-50% results!

As I mentioned earlier, I have not try Dr John Wu skincare but if anyone interested in reading his articles, please share your thoughts and opinion. If I do decide to spend one last dime it'll be his skincare products. Best wishes to all the women who suffer as much as I did and hope there is a true answer from a real Doctor.

Hi @shao3 - Did you ever try the Naimion products? I also came across his site and am wondering if he's legitimate.
Hi @shao3 - Did you ever try the Naimion products? I also came across his site and am wondering if he is legitimate.
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