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How can I remove brown marks on my legs?

Aesthetic Medicine

Greetings Doctors,

I like to seek advice regarding those brown marks due to insect bites and cuts on my legs. Some were close to 1.5 years and others are new scars. My skin colour is pretty fair and thus, the brown marks make it unsightly. I had visited dermatologists and tried lightening creams such as 4% of hydroquino and crystal tomato but none seems to lighten those marks. I was thinking of laser but I heard that it will darken the spots and there is risk of recurring. So I am confused what is the best treatment to lighten and eventually remove those brown marks on my legs.

Thank you so much for your time and your kind reply in advance!!! Please help me!!

DOCTOR’S ANSWER (3)

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!

667 views 25 Jan 2018

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

 

149 views 27 Mar 2019

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.

668 views 25 Jan 2018
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