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 I've had bad hyperpigmentation since I was 16. It has gotten somewhat better, but they still remain with Icepick scars. I think most of it has to do with my constant time in the sun during he sports, but I'm 20 now. So my dermatologist has been putting me on tretinon and aczone and I have seen slight improvement with 4 months of use. But the main thing that won't go away are the ice pick Scars that make my pores look TERRIBLE under florescent light. 

I've bought the AHA from the store on this site, but have yet to use it. Idk if it'll help considering I'm already on two topical treatments. Or should I stop using tretinon all together considering it has been 5 months. thanks for your help.





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@sbabs45 Hi there we have some challenges with your care. Mainly Melasma is reoccurring. You must use sunscreen. There are prescript creams like Tri Luma for it. Which has tretinorin, hydroquinone, and a steriod. Speak to your Dr about this. Vascular laser's (picosure is used for Melasma) can be used with Melasma to combat hyperpigmentation issues and must be done several times. Because you have ethnic skin it also gives us a challenge. As tca cross would normally be done for icepicks, with your skin type this can lead to hyperpigmentation issues that get worse from treatment, the icepick would be replaced by a dark spot. Goto a Dr familiar with your skin type if you decide to do treatment, ... ask how many patients have you treated with my skin type and icepicks. RF needling with insulated needles are effective in your skin type and will help shrink scarred pores and icepicks somewhat. I have seen punch excision done for this type of scar in your skin type especially the bigger icepicks. I think your biggest challenge is finding a aesthetics Dr familiar with your skin type and able to treat acne scars. 

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Would you suggest still using tretinoin and aczone. will that at least get rid of the hyperpigmentation and melasma  I still have.

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@sbabs45 I am asian with dark skin and also struggle with hyperpigmentation. I don't have melasma, which is rarer in men, but I have issues with pigmentation after acne lesions and scar treatments. There are a variety of treatments which you can use to treat it. If you are in the UK, there appears to be a hyperpigmentation specialist that has a clinic, aptly called The Hyperpigmentation Clinic. If you are in the USA, Dr Rullan in San Diego, is a specialist for ethnic skin types like us (FYI: this is my dermatologist that I fly to from San Francisco to see).

You'll have to try out different ones to see is most effective with minimal irritation. Currently, I am using Tretinoin 0.05%, Azelaic Acid 4%, Alpha Arbutin 2%, and Niacinamide 5%. Topicals take months to work, so be patient. Of course, always wear sunscreen. I'm currently using a tinted mineral-based moisturizer by LaRoche Posay. It looks ashy at first, but once it oxidizes it blends into my skin fairly well. For prescription topics (Tretinoin, Azelaic Acid), I use Curology. For the rest I use The Ordinary (Alpha Arbutin) and Dr Sam's (Niacinamide-based moisturizer).

High concentrations of topical lighteners are available as ingredients in skin peels. Dr Rullan, who is in San Diego, specializes in this for ethnic skin types.

Energy devices
As mentioned earlier in the thread, Picosure is shown to work well for pigmentation issues on darker skin tones. Dr Lim talks about it here: 



Edited by superburrito

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