Tuesday, October 21st, 2025

Preventing PIH After Acne-Scar Lasers (for Fitzpatrick IV–V)

Q: How can I prevent PIH after CO₂ laser?

Before CO₂ laser, prepare with pigment-balancing skincare and avoid UV exposure. Use conservative settings and follow prescribed post-laser care to reduce inflammation and pigmentation.

Q: Is RF microneedling safer than CO₂ laser for darker skin?

Yes. RF microneedling delivers heat beneath the surface, bypassing melanin-rich layers and reducing risk of post-inflammatory hyperpigmentation in Fitzpatrick IV–V skin.

Q: How long does PIH last if it occurs?

Mild PIH often fades within weeks to months with consistent sun protection and pigment-modulating skincare. Medical review ensures timely treatment if it persists.

Preventing PIH After Acne-Scar Lasers (for Fitzpatrick IV–V)

Post-inflammatory hyperpigmentation (PIH) is one of the most common concerns among individuals with darker skin tones undergoing acne-scar laser treatments.

Here’s how to minimise risk and achieve clearer, more even skin safely.

Understanding PIH After Laser Acne-Scar Treatments

Post-inflammatory hyperpigmentation (PIH) refers to the dark marks that appear after inflammation or injury, including after aesthetic procedures like lasers.

In Fitzpatrick skin types IV to V—typical among many Asian and darker complexions—melanocytes are more reactive, increasing pigment production after trauma or heat.

While lasers remain an effective way to remodel acne-scar tissue, improper settings or post-care can trigger unwanted pigmentation. Prevention is therefore the key.

Why Darker Skin Needs Special Laser Care

Melanin-rich skin absorbs more light and heat energy, making it more prone to inflammation and PIH. This doesn’t mean lasers are unsafe—it means energy type, wavelength, and technique matter even more.

Heat management: Using conservative fluence and longer pulse durations reduces epidermal overheating.
Fractional delivery: Treats microscopic zones while sparing surrounding tissue for faster healing.
Energy selection: Radiofrequency (RF)-based devices like Secret RF bypass surface melanin, offering safer dermal remodelling.

CO₂ Laser vs RF Microneedling: What’s Safer for Fitzpatrick IV–V?

Both modalities improve acne-scar texture but differ in energy delivery.

Parameter	Fractional CO₂ Laser	Secret RF Microneedling
Energy type	Light-based (10,600 nm wavelength)	Radiofrequency-based (bypasses surface pigment)
Depth of action	Ablative, superficial to mid-dermis	Thermal coagulation in mid-dermis via insulated needles
PIH risk in darker skin	Higher if fluence too strong or downtime prolonged	Lower; minimal epidermal disruption
Downtime	3–7 days (redness, micro-crusting)	1–3 days (mild erythema or swelling)
Best suited for	Deeper boxcar or rolling scars needing resurfacing	Textural irregularities and mixed-type scars

Learn more about each modality:

Expert-Recommended Ways to Prevent PIH After Laser

Preventing hyperpigmentation begins before treatment and continues well into recovery. The following checklist can help minimise risk:

Timing	Risk-Reduction Steps
Before treatment	Use broad-spectrum sunscreen ≥ SPF 50 for at least 2 weeks Avoid active tanning or UV exposure Pre-condition skin with pigment-stabilising serums if recommended
During treatment	Ensure device settings are tailored to skin type (lower fluence, longer pulse) Use fractional or insulated-needle systems to limit epidermal injury Apply cooling or topical antioxidants immediately post-laser
After treatment	Continue strict sun protection and gentle cleansers Avoid exfoliants or actives until healing completes Report early signs of pigmentation promptly for medical management

Frequently Asked Questions

How can I prevent PIH after CO₂ laser?

Pre-conditioning the skin with pigment-balancing skincare, avoiding sun exposure, and following prescribed post-laser care are crucial. Your doctor may also recommend starting with lower energy settings and fractional coverage for safer resurfacing.

Is RF microneedling safer than CO₂ laser for darker skin?

Generally yes. RF microneedling delivers heat directly into the dermis through insulated needles, sparing the epidermis. This reduces the likelihood of PIH in Fitzpatrick IV–V patients while still stimulating collagen remodelling.

How long does PIH last if it occurs?

Mild pigmentation typically fades within weeks to a few months with topical brighteners, sunscreen, and medical follow-up. Early management helps prevent long-term marks.

Safe Acne-Scar Laser Planning in Singapore

Every skin tone deserves a tailored approach. If you have darker or Asian skin and are considering laser resurfacing, request a personalised assessment for a safer, more even outcome.