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  1. #1
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    Default V-Beam Hyperpigmentation Information

    Hello everyone, it's me again, LBW

    Exactly 4 weeks ago I underwent a purpuric v-beam treatment for some red marks on my face. The bruising faded after about 2 weeks, however, one area of the bruise has simply stopped fading since then. My next derm appointment is in a month, but I am fairly certain that this is no longer the bruise healing, but rather hyperpigmentation.

    Reading around the site, I have found some info on the matter, but I want to make a thread that truly gathers all the information possible, so that everyone suffering from this can easily find out more. If everyone were to describe their experiences regarding hyperpigmentation, I am sure that it would help many others out there.

    Perhaps we can make a list of questions, and people can then answer these questions, giving everyone a better sense of what to do or expect.

    Questions like:
    1) How would you describe your hyperpigmentation? (color, size etc.)
    2) When did you realize you had hyperpigmentation?
    3) Derm's info regarding hyperpigmentation (solutions, dangers etc.)
    4) How long did your hyperpigmentation take to resolve?
    5) Did you do anything to speed up the fading process?

    Feel free to add any more questions you may have.

    I'll answer them first.

    1) My hyperpigmentation looks like a reddish-brownish mark. In certain lights it looks brown, and in others it gives off a more reddish-orange hue.

    2) I suspected I have hyperpigmentation last week at around the two and a half week point, when this area of the bruise just stopped fading. There has been little change (if any) between that point and now regarding the appearance of the mark.

    3) Though my next appointment is in a month, I was able to see my derm at the three week mark, expressing my concerns. He asked whether I blistered at all, which I didn't, but I did scab slightly (ironically in part of the area that is now hyperpigmented - coincidence?). He didn't seem very concerned and believed it would resolve itself fairly soon, but I am doubtful. He said it may be iron deposits in the skin, but that I would have to come in next month in order for him to be better able to assess the situation.

    4) It has been only 4 weeks since the treatment itself, so I have no idea how long this would take to resolve. If I had to guess; many, many months.

    5) I have done nothing yet but wait, hoping that this magically fades away soon. I don't want to use any creams either, as they are too strong for my skin. I have heard from some people that NON-BRUISING v-beam treatments, counter-intuitively, can help in reducing the hyperpigmentation left behind from the purpuric treatment. Apparently the v-beam targets both melanin and hemoglobin. However, I am scarred about this for fear of making things even worse.

    This has been my experience. Please, if you have been through or are going through the same problem, share your experience with others. It will definitely help, even if just to ease the mind. Also, don't feel restricted to just answering the questions, if you have other info, just write it out, the question format is just a simple way of keeping things organized for everyone.

    I hope to make this the most comprehensive thread regarding PDL hyperpigmentation.

    Thank you for your time!

  2. #2
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    Have you read the other threads on hyper pigmentation? I think they cover things pretty thoroughly.

    I've had I think five heavily purpuric V Beams and about 8 non purpuric since August of 2009. I went monthly for a while and now go bi monthly.

    I've had massive hyper pigmentation, each time following a purpuric V Beam.

    The hyper pigmentation always covered the exact same area that had been bruised by the V Beam. The broken blood vessels healed, leaving the brown stain.

    I expected this to happen, having read about it.

    I first saw it after my first purpuric V Beam healed, maybe a month later.

    My Dermatologist said the body in its wisdom hoards iron from the broken blood vessels, and that this was the brown tea-colored stain I saw.

    He explained that the subsequent non-purpuric V Beams we had planned would remove it, and that it would fade on its own in six months to two years.

    My last purpuric V Beam was in July 2010; since then I had two non purpuric treatments; by now my hyper pigmentation is completely gone.

    My Dermatologist also said there is nothing I could do to speed up the fading, other than non-purpuric V Beam.

    My rosacea is awful and my flushing is really a problem, so I never saw my hyper pigmentation as an issue.

    After all, my hyper pigmentation didn't hurt, like my terrible flushing did. And my face was already so red, I didn't care if it was brown too. Mainly I wanted the flushing to stop.

    So my Dermatologist and I were dealing with a horrible problem -- very severe vascular rosacea worsened by menopause and repeated sinus infections, causing terrible flushing that sometimes flared for 8 hours or so before it subsided, creating terrible pain, fear, anxiety, and swelling in me.

    Given that, you can probably understand why I never really fretted about some hyper pigmentation.

    My rosacea is much better now. My hormone fluctuations have settled down and my rosacea no longer flares totally out of control the way it did even six months ago.

    And my 13 V Beams have improved things considerably.

    I've settled on non-purpuric treatments now, every other month, because I just can't stand the terrible rebound flushing and post-treatment misery that the purpuric treatments cause.

    I'm glad I had the bruising treatments I did, but if you see the post-treatment pics I've posted I'm sure you will understand why I just don't want to go through that again.

    Hope this helps.

    -WC
    58 yr old woman
    Rosacea at 48, debilitating at 52
    Clonidine 100mgc ev. 8 hrs;
    Remeron 15mg nightly;
    Zebeta=Bisoprolol=Beta blocker 5mg nightly;
    Brimonidine worked well initially, then MASSIVE rebound flushing and damage;
    Countless IPL with Lumenis One;
    Now purpuric V Beam with Candela Perfecta; more clearance, less downtime than IPL;
    Botox (with mesotherapy needles), good not great results;
    Monthly Kenalog injection to blunt debilitating flushing.

  3. #3
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    Thanks for your input WC,

    I wonder, how long do you think your hyperpigmentation would have lasted if you did not get the non-purpuric v-beam treatments? (Based on the rate you saw it fading)

    I wake up every morning now with a great sense of uneasiness over what has happened, and find myself on these boards trying to console myself. I swear I must have read all the same info 10 times now. I wake up with two primary feelings. The first: worry. Will it fade? How long will it take? What can I do? Should I get another lighter treatment? The second primary feeling: anger. Why did this have to happen? I was so close. I could have felt happy and normal again but now I have to deal with this issue.

    I just want to make sure I understand you correctly when you say non-bruising treatments though. Obviously this means no purpura, but you're telling me that to come out with very red areas where the laser zapped is ideal i.e not just walking out with no indication of laser treatment? How long did it take to find out if the laser helped your hyperpigmentation afterwards? I'm guessing upwards of a month? Or is it sooner than that?

  4. #4
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    I have no idea how long my hyper pigmentation would have lasted without the subsequent non purpuric treatments.

    Yours will fade. My doctor said it may take up to two years. If it distresses you, why not have a few non purpuric V Beams to eradicate it sooner.

    I don't mean to be dismissive of your worries about this, but it's just not the problem most of us on this board are dealing with.

    Many of us are dealing with intractable facial flushing that directly impacts our quality of life. My face gets hot and red and burns and flushes at the slightest trigger.

    A bit of hyper pigmentation, which does not hurt and does not affect my ability to move freely through the world the way this horrible flushing does, is just not an important issue to me.

    I care about the pain and disability my rosacea causes, not a wee bit of brown stain on my face.

    Also, I did NOT say that coming out of a non purpuric treatment with a red face is ideal.

    I said that I come out of a non purpuric treatment with a red face.

    Those are different things. Words have meaning -- please do not assume I'm saying things that I'm not.

    It took a few weeks after the second non purpuric V Beam to see that all the hyper pigmentation was gone.

    Please try to stop obsessing over this. You really have to give it about six months after a V Beam to see results, and results are cumulative. It's not fair to expect to see good results after only one or two treatments.

    So patience, please. Try to focus your mind on things other than your face. Easier said than done, I know.

    -WC
    58 yr old woman
    Rosacea at 48, debilitating at 52
    Clonidine 100mgc ev. 8 hrs;
    Remeron 15mg nightly;
    Zebeta=Bisoprolol=Beta blocker 5mg nightly;
    Brimonidine worked well initially, then MASSIVE rebound flushing and damage;
    Countless IPL with Lumenis One;
    Now purpuric V Beam with Candela Perfecta; more clearance, less downtime than IPL;
    Botox (with mesotherapy needles), good not great results;
    Monthly Kenalog injection to blunt debilitating flushing.

  5. #5
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    I'm sorry if I have offended you. I realize this is not the ideal place to discuss these issues but this is one of the few forums on the web that has people who know what they are talking about.

    I know it may not sound like much to you, but I am 20 years old, and for the past three years my life has been ruined by my obsession with these marks. This issue has impacted me probably more than many people on these boards, I have lost many friends and can't even look my family members in the eyes anymore over the shame I feel regarding these marks. I realize that it is wrong, and that's why I am making appointments to see a therapist next week, to tackle the mental issues as well.

    It's just extremely frustrating since I am also trying to eliminate the physical problem as well, and this feels like it has set me back.

    Regarding the non-purpuric treatments, I didn't intend to put words in your mouth, I am just trying to figure out what I should ask my derm for when I go.

    Again, WC, I am sorry. You are one of the only people who is actually taking the time to help me on these boards and for the I am truly grateful. You have no idea what your support means to me and I hope you don't take a dislike towards me, I really am not trying to upset you or anyone on these boards, just trying to keep my sanity.

    Anyways, thank you

  6. #6
    Senior Member nat007's Avatar
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    Hi,

    I've been reading your posts as well lately, and I am very sorry for the stress you are going through now.
    I think WC is right, she has tons of experience with lasers (and severe rosacea, but that's another story).
    I think you already mention it yourself: you are having a big psychological issue with your skin/ your marks.
    It probably doesn't matter or help for you if other people say they are not as bad as you think (which
    people probably HAVE said to you I suppose). Perhaps you are having insecurity issues, have had some
    disappointments in your current life or things are not going as you like, in other areas then your skin?
    If this is the case, sometimes people look for reasons for this in something they cannot controle or dislike
    about their body: too heavy, wrong nose, bad skin, marks on your face. It sounds a bit to me as if your
    trying to get rid of these marks has more significance in your mind then just to have clear skin again.
    It seems VERY important to you, and perhaps therefore you are so in panic at the moment, as there is
    much 'at stake' with these marks not fading as you hoped?
    If this is the case (and I am only assuming), then it would be indeed a good idea to see a therapist and
    discuss this. The thing is, that most people on this forum are beyond worrying and depressing about solely
    the way their skin looks: many have a lot of physical pain from it and a severe limitation of their lives.
    Therefore, it might be that not everyone can relate very well to your story, as you have 'only' some marks on a further healthy skin. This doens't mean it is not something very important for you. But it does mean perhaps
    you are obsessing a bit too much about the wrong things perhaps: of course it is very sad and unpleasant
    what is happening with you right now, but when put in perspective, it is for many here perhaps not the drama
    that it is for you.

    I am really sorry you are experiencing all this stress now over it and sincerely hope they will fade in time,
    as they seem to do with most. I hope you can find out for yourself why these marks are such a big thing in your life and why they keep you (or you keep yourself over it) from living a happy and confident life.

    Best wishes Natalja

  7. #7
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    Default V-Beam to remove hyperpigmentation CAUSED by purpuric v-beam

    To anyone who follows my posts here,

    I am still 7 months later battling the hyperpigmentation left by an aggressive purpuric v-beam treatment. The mark is a pinkish brown but in some lights looks hideous. I don't care if it doesn't fade 100%, but I would still like some improvement.

    As you are probably aware, hyperpigmentation after v-beam is usually the result of iron deposits left in the skin after it has been lasered (leaving the copper staining).

    So, I am coming to you all for your experience and guidance. Would another gentle NON-PURPURIC V-Beam treatment help break up these deposits and fade the hyperpigmentation? I know WrinkledClue swears by this method, but I am just wondering if everyone else is in general agreement with this and can share their insight. The absolute LAST thing I want to do is make it worse, obviously.

    Any replies are appreciated,

    thanks

  8. #8
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    WrinkledClue has previously given you very good advice based on experience ( http://www.rosaceagroup.org/The_Rosa...ormation/page3 )

    You can be sure non-purpuric vbeam has a next to zero chance of hyperpigmentation, and in fact can actually help improve it.

    If you are still unsure in whether or not to go ahead with the non-purpuric vbeam, perhaps it is a good idea to seek a second opinion from a reputable laser Derm.

    Best,
    Last edited by shantelle; 10th July 2011 at 04:27 AM.
    Shantelle

    31 Year old female from NZ

  9. #9
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    I know, but I was hoping others would come forward to confirm this as a successful method to help fade the hyperpigmentation. The mark is not 100% brown either, more pinkish brown, which sort of worries me, because WrinkledClue describes hers as brown.

  10. #10
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    I am so sorry you are still dealing with hyperpigmentation! I know you and I had conversed on this a while back. Mine ended up fading around the 5 or 6 week mark. I think you need to speak to another laser doctor. You certainly can use another non-purpuric vBeam...but there are other lasers too that can help break up the iron deposits - like the Q switch lasers (I think that is the name). You need to go to someone who will put you under a woods lamp - determine the layer of skin where you hyperpigmentation is (epidermis or dermis) layer and then decide on the best laser based on that outcome. Some lasers are better than others depending on the depth of the hyperpigmentation.

    Hope that helps!!

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