Skin care after any laser treatment is very important for healing and for the best overall results of any skin photorejuvenation procedure. Darker skin type patients require extra attention to prevent laser surgery hyperpigmentation.
The melanocytes (skin cells producing melanin – the pigment in the skin) of dark-skinned individuals tend to be more hyperactive to any stimulus, particularly inflammation after laser surgery. Therefore, the use of hypopigmenting agents both pre and postoperatively is of considerable importance. Many combinations of tretinoin, hydroquinone, topical steroid, α-hydroxy acids, kojic acid and/or azealic acid have been advocated by aesthetic physicians.
For the treatment of the hyperpigmentation that follows several laser procedures, many practices favor 0.025% tretinoin cream mixed with 4% hydroquinone to be used initially at night. To assess the degree of irritation, the patient is instructed to apply the cream to back of their ears, and if tolerated, the application is continued on other exposed areas. If any irritation develops, corticosteroid in topical form is added to the combination (1% hydrocortisone).
Patients are typically advised to use 5% glycolic cream in the morning, and if the pigmentation still persists, mild glycolic acid peel (20-30% solution) is performed 9 weeks after the laser procedures. Combinations of Vitamins C and E and glycolic acid as well as many other medical grade skin care products are commercially available and may be very useful for the prevention and treatment of hyperpigmentation after laser skin resurfacing and all non-invasive laser treatments.