Permanent hyperpigmentation following laser hair removal using the dynamic cooling device

Laser induced hyperpigmentation is a frequently encountered complication in patients treated with lasers for hair removal in Fitzpatrick skin types of 3 through 6. Most reports implicate excessive laser energies and inadequate epidermal cooling as the primary cause. Recent reports over the past decade have shown decreased side effects in dark skin types with the advancements in longer wavelength lasers such as the diode or Nd:YAG laser. The authors report a new complication from the use of low laser energy 12 J/[cm.sup.2](Gentlelase[R]; Candela Corporation, Wayland, Mass) or less with high cryogen spray (50-ms duration/40-ms delay) using the dynamic active cooling device (1,1,1,2-tetraflourethane [DCD [TM]; Candela Corporation).The majority of the patients treated with these settings resulted in persistent hyperpigmentation further referred to as postinflammatory hyperpigmentation (PIH).

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