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If iron-overloaded patients are not treated with iron chelation therapy, the continuous supply of surplus iron accumulating with each blood transfusion can eventually overload macrophages and spill into the bloodstream in the form of reactive non-transferrin bound iron (NTBI), resulting in irreparable damage to hepatic cells and other critical organs 10

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For Fitzpatrick types IV to VI, the safest and most effective approach usually avoids aggressive IPL and instead combines Pico laser at conservative settings or microneedling with PDRN, gentle mandelic or low-glycolic peels, and prescription topical and oral brighteners, all under strict sun protection