Which Fitzpatrick skin types are at highest risk for post-inflammatory hyperpigmentation after laser hair removal?

• A. Fitzpatrick I–II
• B. Fitzpatrick III
• C. Fitzpatrick IV–VI
• D. All skin types are equally at risk

Answer: (C)

The risk of post-inflammatory hyperpigmentation after laser hair removal is driven by how much pigment (melanin) is in the skin and how reactive the pigment-producing cells are to the laser-related inflammation. Darker skin types have more epidermal melanin, and their melanocytes respond more readily to inflammation, so laser energy can trigger an inflammatory process that increases melanin production and leaves pigmented spots. That makes the chance of PIH higher in Fitzpatrick types IV through VI. Lighter skin types (I–II) have less epidermal melanin, so they absorb less energy in a way that leads to pigment change, resulting in a lower PIH risk. Type III sits in the middle with intermediate risk. So the highest risk is Fitzpatrick IV–VI.