Question
Yes these pigmentation are likely post inflammatory hyperpigmentation.
Chemical peels can be done over these areas. In this way, skin turnover is stimulated and lightening of these pigmentations are facilitated.
Non-ablative laser eg. NdYag laser also help with these pigmentations. It has to be a gentle laser setting, which will not worsen the pigmentation, but instead help to break down the melanin deposits. Many sessions of laser will be required.
What you have described is Post-Inflammatory Hyperpigmentation (PIH).
Lasers would definitely be one of the 1st-line options that I would use.
With the right laser settings, the risk of the spots darkening is actually fairly low.
Topical creams etc do help but do not reach the deeper layers of the skin which may explain why you have reached a plateau.
Hope that helps.
All the best!
The condition is called post-inflammatory hyperpigmentation (PIH).
This darkening of the skin is a response to to the injury or inflammation from the bite reactions. Unfortunately, as you already know, it takes a heck of a long time, i.e. two years, for complete fading. Fortunately for you, PIH is not permanent.
I would recommend you use a combination of lightening creams and superficial chemical peels at monthly intervals. You will need to use a good insecticide spray to prevent further bite reactions to get overall clear skin.
I would not recommend any light or laser based system as the heat energy can cause further heat injury to the skin and make the darkening worse. Especially on the legs. And they are expensive!
My best advice to you is that slow and steady wins the race.
Hope you found this useful.
regards,
Dr Benjamin Yim Fu Chuen
Good questions! I agree with Dr Chua’s reply on the pros and cons of Fractional CO2 lasers versus Infini RF. In addition, I would like to address your question on the ideal length of time between subcision and Infini RF treatments. The ideal interval between treatments is 4-6 weeks. This is to allow for adequate skin recovery. Hope that this answers your questions!
PRP at the present moment is not available in Singapore. It does help with acne scarring though, and you might have to go to neighbouring countries to do the treatment (including Malaysia). Having said that, you can consider Rejuran/skin boosters/microneedling that can help in a similar fashion. Your 2nd question on which is better — it depends on the severity and type of scars. But usually Fractional laser is the backbone of laser therapy. So consult your doctor early to discuss the available options.
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