A couple of years ago I got a bacterial infection from shaving on my legs. There was about a quarter size sores all over my legs. I went to my doctor and got some antibiotics and used Polysporin on them. Then they started healing but i picked at the scabs and they left brown discolored marks where the sores were. They have lightened and faded over the years after about 5 years but I can still see them and they make me feel so self conscious that I haven't worn shorts/skirt/shown my bare legs in years. I am so embarrassed I even avoid getting intimate with men to avoid having to explain why I have dark marks on my legs. The discolourations are completely flat but they are seen so clearly on my butter pecan skin colour. Please advise me on how I can fade these marks with some type of treatment I have used over the counter hydroquoin 2% (Ambi Fade Cream). I am not achieving the results I desire. I hope to find a way to get rid of these scars so that I can have confidence. The scars are completely flat its just a dark spot left behind.
2014-12-11 11:12:07
Hello Thanks for posting your query. I can understand your concern for the unsightly scars. Well these scars are due to post inflammatory hyperpigmentation. Hyperpigmentation occurs as brown macules or patches often with a poorly defined border irregular in outline and usually with little surface change. It is usually due to inflammatory conditions like infections or acne or trauma both of which were present in your case. It can either be epidermal or dermal melanosis. It is light brown to black with a lighter brown appearance if the pigment is within the epidermis (ie epidermal melanosis) and a darker gray to bluish appearance if lesions contain dermal melanin (ie dermal melanosis). In your case it looks more like epidermal melanosis. Regarding the treatment part it is quite tough for post inflammatory hyperpigmenttaion. Topical treatment is quite effective for epidermal hypermelanosis but none is proven effective for dermal hypermelanosis. Daily use of a broad-spectrum sunscreen (sun protection factor [SPF] 15 or greater) is very useful. Hence considering the topical treatment one is hydroquinone which you have already used. Apart from that tretinoin cream corticosteroids glycolic acid (GA) and azelaic acid are quite useful but please do not use them without medical guidance as they have potential side effects as well. Moreover a combination of topical creams and gels chemical peels and sunscreens may be necessary for significant improvement. Glycolic acid peels in combination with tretinoin and hydroquinone are an effective treatment of postinflammatory hyperpigmentation in dark-complexioned individuals. This is usually followed by topical steroids. But as mentioned before they are useful for epidermal hyperpigmentation. Other treatment options include use of trichloroacetic acid and gentle cryotherapy with liquid nitrogen But they can cause tissue necrosis and hence should be used with caution by a medical specialist. This is quite effective in individuals who are not dark skinned. Lastly fractional photothermolysis may be used after or in conjunction with ablative carbon dioxide laser resurfacing and this is quite effective for dermal melanosis. You can get the topical treatment prescribed by your dermatologist (one of them being hydroquinone which you were using) and if it fails then other treatment options can be tried. But treating post inflammatory hyperpigmentation requires patience and you should regularly follow up with your dermatologist. Hope that this information helps and hope that you get better soon. Wishing you good health.
2014-12-11 11:13:12
