Hypopigmentation following dye VL harmony laser for photorejuvenation

Lasers e EBDs
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Anonymous

setembro 30º, 2025 14:15

Patient description

55 year old lady, skin type III, healthy. 

Case description

This 55 year old lady had a facelift in April 2025 and had her scars treated back then with the Dye VL Harmony laser, fluence 12 mj/cm2 with improvement and no complication. She then attended for "photorejuvenation" and wanted to treat some small lentigines on her cheeks. She is skin type III. She was tanned at the time and advised against treatment but insisted. My colleague went ahead and treated her with very conservative settings, fluence 7mg/cm2 and 100 percent cooling. She was not compliant with post treatment care. She never wears sunscreen despite explanation that it is not toxic. She also used a face mask (? enzymatic peeling or something with exosomes) which she does not want to disclose. 

She then developed purpuric erythema 2 days later which was treated with an emollient cream and a mild potency steroid- but unsure regarding her compliance. The redness and crust resolved 8 days later and she was left with hypopigmented linear streaks in her tanned skin. My colleague injected the surrounding areas with vitamin C and tranexamic acid (mesotherapy) to try and blend the areas. 

I'm not sure if anything else can be done to speed up her recovery? I asked her to use sunscreen and protopic (low evidence)but she will not use these. Any suggestions would be gratefully received as she is extremely disappointed in the hypopigmented areas. Many thanks! 


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Dr. Hans Joachim LAUBACH

Dermatologista, França

setembro 30º, 2025 17:29

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