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Thread: V-beam Induced Hyperpigmentation

  1. #11
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    Hi Slivovice,

    You're welcome. Thank you too for sharing.

    Yvette

  2. #12
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    Hello All,

    Thought I'd report about my visit today to the dermatologist, not the one who did the laser treatment, but one that I wanted to see to get some feedback on my PIH. She verified that this is indeed PIH, and that seven weeks is a very short period of time when it comes to healing of the skin. While I was pleased to learn that this condition will improve, i.e., the darkness will fade, I became a bit deflated when she said that I should expect to see significant improvement at around four months (though not full improvement, which will continue after that). I think these timelines are more or less in step with things I've heard from folks here. In any event, this means that I still have about two more months to go, which seems like a very long and daunting wait. It's been a long two months (or seven weeks) thus far.

    The doctor gave me a prescription for Tretinoin, suggesting that this will speed up the fading process. When I asked her about side effects, especially if this will bring back or create new telangiectasia, she flatly said it will not produce the veins like those I had zapped and it shouldn't have any side effects other than, possibly, reddish and flaky skin during the first two weeks of use. Can anyone speak to the pros and cons of Tretinoin?

    Many thanks.

  3. #13
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    Silvo--

    Great to hear that you went to the derm. and have some positive news . It is interesting about the prescription. Have you filled it yet? Are you going to do it?

    In The Skintype Solution by Bauman she discusses the various treatments for hyperpigmentation/melasma among other things. I borrowed the book from the library. I may try to get it out again though to see what she has to say about what you were scripted. It sounds like a retinoid. Now I believe Dr. Bauman said those with rosacea should not use retinoids. Is your skin hypersensitive to topicals? Perhaps though the one you were scripted is gentle enough for rosacea skin.

    My regular derm (not the one who did the laser) didn't think I should try a topical for the hyperpigmentation and just wanted me to let time do its work or get IPL. My skin though is hypersensitive to topicals. I would like to try a topical to speed things up if it didn't aggravate my skin. I am now 3 mo. post the purpuric vbeam.

    I will be very interested as to how things go for you. Good luck.
    Roz

  4. #14
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    Hi-

    Not all retinoids are created the same, some can be beneficial for those with Rosacea (papules or acne type). Which prescription retinoid did your Derm. prescribe?

    Milder retinoids, those like Differin, Ziana, and Atralin are newer prescription retinoids formulated for sensitive skin. Used in moderation (a few times a week at night always skipping a night) can really help reduce acne/papules without causing redness or irritation. I use Ziana, which is 1.2% clindamycin (antibiotic/anti-inflammatory) and has .25% tretinoin in a glycerin base. It helps keep my skin clearer and also helps with the inflammation. It's actually less harsh on my skin than Metrogel. It's interesting Bauman discourages retinoids, though promotes Finacea gel which is 15% azelaic acid - which can be very strong. I used Finacea for several months - in the end really worsened my skin!!

    I'd say if you were prescribed one of the newer, more gentler retinoids mentioned above and have acne/papules - give it a try. Try a test spot first. If you were prescribed, say Retin A or Retin A micro, I'd question your Derm. These are more harsh, contain more % of retinoid, and I don't believe they are formulated in a hydrating base and may cause more exfoliation, peeling, and redness....

    I forgot to add some of the Pro's and Con's of retinoids...

    Pro's

    Helps clear and exfoliate the skin; brings newer, fresher skin to the surface
    Reduces acne, papules, pustules, blackheads, clogged pores..
    Anti-aging; good for skin rejuvenation for a younger, healthier look

    Con's

    Can cause redness, peeling, and irriation if used too often or too much is used. Using less often and less product reduces chances of irritation. Newer formulations - Ziana, Differin, and Atralin are designed for more sensitive skin.

    Can thin the skin and make broken capillaries more visible for some. I've not had this experience, since I use Ziana which is more gentle. I also use a very small amount and only use 2-3x a week at night (always skipping a night)

    Can make your skin sun sensitive. Always, use SPF 30 during the day to protect your skin. Use gentler skin care if needed to keep your skin hydrated: cleansers, moisterisers, etc. Don't use any retinoids or exfoliating agents (ie. AHA's, BHA's, retinoids, benzoyl peroxide) three to five days prior to laser. You may get hyperpigmentation or irriation from the procedure. Ask your Derm. for specifics.

    If you have moderate-severe erythema and/or very sensitive skin; retinoids will probably be too harsh. Ask your Derm. if your skin type is suitable or if there are other topicals that are better.

    Good luck.
    Yvette
    Last edited by Yvette; 15th September 2009 at 04:28 PM.

  5. #15
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    Yvette--

    Thanks for a very helpful post!
    Roz

  6. #16
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    Yvette--
    I did some research on retinoids, and Ziana in particular. Is it the Ziana Gel formula that you have had good luck with?



    Slivo--
    It seems that Ziana is a combination of the drug that you were scripted, tretinoin and clindamycin phosphate.
    I wonder would the tretinoin alone , or ziana where it is combined with the clindamycin phosphate be more gentle? Maybe Yvette would have a thought on this.

    I am also trying to gather this information for my appt. with my derm next week.
    Roz

  7. #17
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    Hi Roz,

    Yes, Ziana is a gel and this is what I use. It's great stuff! It works for my skin nicely.

    Yvette

  8. #18
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    Thanks for this useful information. My script is for Tretinoin gel alone, 0.05%. I am not sure if I want to use it, however, for fear that it might worsen the issue. Frankly, I am trying to accept the fact that there just might not be anything but time to rectify the hyperpigmentation problem. Looking online for ideas and encouragement is not terribly helpful, as there are so many conflicting views about what will and won't work, not to mention the depressing stories and warnings that lead me to think this might be permanent. That's not a scenario I care to entertain!

  9. #19
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    Hi-

    I believe with time the hyperpigmentation will resolve. Our skin regenerates itself every 2-4 weeks or so. The tretinoin cream .05% may be a stretch - something more like .025% would be much more tolerated for sensitive skin. Can you ask your Derm. if he/she has samples of the newer, gentler retinoids - Ziana, Differin, or Atralin? Or, Renova, is available at .02% but I used that years ago and though it's not bad, it has a slight perfumy scent. Ziana, Differin, and Atralin are fragrance free. If you opt to forgo the retinoid, you will likely see a reduction in the hyperpigmentation over the next few months. Stay out of the sun and wear SPF as well.

    Yvette

  10. #20
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    Slivo---
    I would think you should start with a lower dose retinoid if you are going to go that route. You say that you are now thinking of scrapping the retinoid idea after your research. As I am in the same situation as you are, could I ask what is causing you to pull away from use of a retinoid???

    Please don't get too negative like thinking the hyperpigmentation will be permanent. Didn't the derm say it will fade in about 4 months? Even if you don't do the retinoid , there should be quite alot of improvement in a few months. As I said I am now at 3 mo. and have had alot of improvement though it still bothers me some. I am hoping it will get better.

    Yvette-
    I read some review of ziana at acne.org. Some people complain that ziana seemed to make their skin oily. Does it seem oily to you? Does it leave your skin red at all? Also , are you a person prone to broken capillaries? I am and I wonder whether ziana could aggravate that issue. Any thoughts on that?

    Roz

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