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Hyperpigmentation and Melasma with Icepick Scars

MemberMember
1750
(@beautifulambition)

Posted : 02/01/2019 12:00 pm

@sbabs45Hi 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 areeffective 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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MemberMember
90
(@superburrito)

Posted : 02/03/2019 3:25 am

@sbabs45I 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).

Topicals
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).

Peels
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:

 

 

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