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Have folliculitis, opted for laser hair removal. Tried kojic acid, arbutin cream. Safe to have laser treatment?

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Practicing since : 2006
Answered : 2015 Questions
hello madam , this is Dr. XXXXXXX from chennai , previous i had folliculitis issues in my neck and it ended up in post inflammatory hyperpigmentaton , as it was a chronic issue for me i opted for laser hair removal ( did 3 sittings in neck , NdYAG laser was used) after laser there is almost 100% reduction in folliculitis ,but the pigmentation is still there for more than 2 years , i tried almost everything ( retin a along with hydroquinone of all strengths , kojic acid , arbutin cream,tri luma , someother scrub stuffs too) they all reduced it 50%( continues treatment continuously for 3 months) , pigmentation is still there and im doing battle with it , finally ive decided to do undergo laser ( for pigmentaion , q switched NdYAG), this is my history , my questions is
1) is it safe ?
2) is it effective ?
3) how many sittings needed ?
4) anyother alternates ( there r lot of lasers available )
5) cost ?
6) u have any suggestions regarding my history
Ill join a picture of myself for u to get a better idea , also my beard area is pigmented , can laser be done on that too ?
No addisons disease , no other pigmntation issues anywhere in body , please help mam
, plz check reports for picture
Posted Fri, 24 May 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 8 hours later
Thanks for writing to us.
You seem to have been suffering with acne keloidalis nuchae which is due to friction and close shaving that leads to inturned hair invoking inflammation and raised red bumps. The treatment offered in form of lasers was apt for the same.
Now coming specifically to your queries

Laser for pigmentation reduction is safe and effective. The precautions to be taken are sunscreen application, avoidance of sun and continuation of pigmentation reducing creams for better results.

The number of sittings required depends upon the depth of pigmentation. Some people respond in two to three sessions while some may need five to six or more

As far as lasers are concerned Q switched Nd YAG is best. IPL can be tried too but results would be better in Q switched Nd YAG. Another option could be use of peels like Glycolic acid or trichloroacetic acid peels instead of lasers

Cost for lasers varies from clinic to clinic depending upon the setup. Some ,au charge just 1000 tp 1500 per session while some may charge upto 5000 per session.

As I told it sounds like acne keloidalis. Avoid friction and very close shaving in the area to prevent further occurence. If lesions develop start applying a potent steroid cream to help lesion settle

As far as beard area is concerned, frequent shaving imparts a slight greenish or pigmented appearance to all males. However if you feel pigmentation is bothersome, you may use Kojic acid based creams, Glycolic acid or hydroquinone based cream in night to lighten the same. You may also take peeling session. I would not advise lasers in bearded area.

Hope that answered all your query.
Should there be further questions please feel free to write back.
Dr kalpana
Above answer was peer-reviewed by
Follow-up: Have folliculitis, opted for laser hair removal. Tried kojic acid, arbutin cream. Safe to have laser treatment? 2 hours later
Thank u very much mam for replying
im using the best possible multi blade razor in india , i change blades once in two weeks to avoid friction ( though in commercial it is said it can last a month) also im not getting any lesions these days , i need to get rid of pigmentation , also after laser treatment can my skin get back to normal skin tone ?
also ive tried glycolic peels too ( 30%) , did four sittings , but no big results
, this is more like a double edged sword , if i allow my beard to grow it becomes very itchy and irritating , i hope u understand my problem , i cant go to hospital with full beard .
Answered by Dr. Kalpana Pathak 8 hours later
Thanks for writing back.
As far as causative factors are concerned,Acne keloidalis nuchae can be due to constant friction and irritation caused by shirt collar . It is essential to use a sharp edged blade and you can use a blade as long as it s not blunt. So there is no point changing it so often. One should avoid close shaving and short hair cut.. This can be prevented by avoiding too much stretching of the skin while shaving. Also hair cut should be taken just once a month. Shaving of beard too should be done two times to three times in a week. Over face if growing of beard or shaving induces itching and bumps, application of steroid cream and salicylic acid peels would help in treating the lesions. But for pigmentation Glycolic acid or TCA would've better.
As the main cause is reentry of hair back into the hair follicle hence laser hair reduction is the best treatment modality to recent recurrence.

Though peels are effective in reducing pigmentation, the concentration used in your case was mild. You can try take Glycolic peels in concentration of 50 percent to 70 percent. Also TCA peels in 10 to 20 percent concentration should offer good results.
Over face to reduce pigmentation peels in above mentioned concentration can be taken. As peels are being used in a high concentration, it should be taken under a qualified dermatologist's supervision. If peels donot offer desirable results, next option is lasers like q switched Nd yag laser.

Hope that helped!
Should there be any other query, please write back.

Above answer was peer-reviewed by
Follow-up: Have folliculitis, opted for laser hair removal. Tried kojic acid, arbutin cream. Safe to have laser treatment? 5 minutes later
Mam , does the laser remove normal pigment too ??
What's the downtime for laser ?
When will I start to see results ??
Thank u very much for spending ur time mam !
Answered by Dr. Kalpana Pathak 15 hours later
Laser does not remove normal pigment. It would just act on your hyperpigmented area to bring it close to your normal skin colour. Sometimes hypopigmentation is seen in treated area but that is not common.

Immediately after lasers very slight redness, swelling is expected which settles down in couple of hours. Sometimes might require a day or two for the same. Application of calamine, steroid creams and icing of the area helps to reduce redness and swelling.
After lasers if redness, swelling, burning sensation persists for a long time contact your doctor immediately. So as such there is no downtime, you can resume your office job immediately after laser
Sometimes after a first session desirable response is seen. However at least four to five sessions might be required to see good response

Hope that answers all your queries.
Take care
Above answer was peer-reviewed by
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