Treatment of Post‐Inflammatory Hyperpigmentation in Patients With Darker Skin Types Using a Low Energy 1,927 nm Non‐Ablative Fractional Laser: A Retrospective Photographic Review Analysis

Abstract

Background and Objectives: Post inflammatory hyperpigmentation (PIH) can be difficult to treat especially in patients with darker skin types as darker skin carries increased epidermal melanin content. Various treatments available to improve the appearance of PIH may incite further pigmentation thus making treatment extremely difficult and frustrating. The purpose of this study was to perform a retrospective chart and photographic review to evaluate the efficacy and safety profile of a low energy low density nonablative fractional1927 nm wavelength laser treatment for PIH in patients with Fitzpatrick skin types IV-VI. Study Design: A retrospective evaluation of 61 patients with PIH treated with a 1927 nm laser was conducted at a single center. Inclusion criteria required at least 2 treatment sessions so that before and after treatment photographs would be available for comparison and study purposes. Two blinded physician-evaluators using a visual analog scale for percentage of pigmentary clearance in standard photographs assessed treatment efficacy. Results: The mean percent improvement after treatment, evaluated by two dermatologists was 43.24%. The correlation between raters was statistically significant (Pearson's correlation coefficienct of r = 0.59, p < 0.0001). No side effects were observed in the patients treated with the 1927 nm laser. Conclusion: The low energy low density non-ablative fractional 1927 nm wavelength laser is a safe and effective modality for improving post inflammatory hyperpigmentation in patients with darker skin types. Lasers Surg. Med.

1927 nm Thulium Laser Successfully Treats PostInflammatory Hyperpigmentation in Skin of Color

“…e majority of the current patients had either excellent or satisfactory improvement. Similar findings were reported in the few reports that examined the same wavelength in dark-skinned patients with PIH [13,14]. For example, Wilson and colleagues reported 50% improvement after 4 laser treatment sessions with or without topical depigmenting cream among 40 patients with dark skin who had facial hyperpigmentation and/or melasma [13].…”

“…For example, Wilson and colleagues reported 50% improvement after 4 laser treatment sessions with or without topical depigmenting cream among 40 patients with dark skin who had facial hyperpigmentation and/or melasma [13]. Similarly, Bae and colleagues reported 43% improvement after at least 2 laser treatment sessions without topical depigmenting cream among 60 patients with dark skin who had PIH [14]. Interestingly, nonablative 1927 nm wavelength laser was reported to have better response in light-skinned patients with PIH [17,18].…”

“…Treatment of PIH in patients with dark skin is challenging as the treatment itself might provoke inflammatory response and end up exacerbating PIH [10][11][12]. Additionally, only few studies examined the safety and efficacy of laser treatment in skin of color [13,14]. e efficacy and safety data of nonablative fractional laser in Saudi patients is limited [15,16] with no data that focus on new technologies such as 1550 nm/1927 nm dual wavelength laser.…”

Consensus on management of acne-induced post-inflammatory hyperpigmentation: an Indian perspective

“…8 However, these treatment options tend to cause further pigmentation, especially in people with darker skin type. 9 Given the long-standing and relapsing nature of the condition, the treatment of PIH is challenging. Thus, the ideal therapy needs to enhance the efficacy of existing treatment, provide longlasting effects and prevent any relapse.…”

LSM Dermatology Edition: Introduction 2020

“…This is a common problem in a large part of the world and in multi‐ethnic societies such as in the United States where persons of color make up a majority of the population in many regions. In a retrospective review of the experience in a large center with a 1,927 nm fractional diode laser in skin types IV–VI, Bae et al suggest that a low fluence, the low‐density approach might be useful. This observation is encouraging and deserves further study in a controlled manner.…”