What is the best treatment for an 8 month old burn mark that is still visible? (photo)

Sorry to hear that you had sustained a burn on your thigh. Looking from the picture, there may not be any bad scarring from the burn (should be examined closely in the clinic).

It is likely that you have been left with post inflammatory hyperpigmentation (PIH). As it is on the lower legs, the PIH is usually more stubborn and may not heal as well as the other parts of the body. The PIH may take several months and sometimes a few years to resolve spontaneously.

In my opinion, you have the options of

1. leave them alone and allow it to heal naturally;

2. use lightening cream like hydroquinone or the triple combination (hydroquinone, tretinoin and mild steroid) which can be irritating to the skin or more gentle option with peptide based topical. It does take at least 6 months to see results with these lightening creams and if you have not used the hydroquinone for more than 6 months, I would advise to stay patient with this treatment option for now;

3. Pigment laser (start of with a lower setting as there is also a risk of burning);

4. Pigment laser and lightening cream.

I will not recommend a chemical peel for now as it will likely irritate the skin and cause further inflammation and worsen the PIH.

Sunscreen of at least Spf 50 is very important to prevent further darkening of the skin.

If you need further assistance on this skin issue, please approach a plastic surgeon or a dermatologist. All the best and hope you will recover soon.

Regards,

Dr Liew Hui Min

Dermatologist

Hi

It looks like you had quite a severe burn over your left leg that has recovered with a large patch of post inflammatory hyperpigmentation. I do not see any scarring over the patch which is a good thing.

It looks like the hydroquinone and Arbutin cream has not worked well. I am not sure of the concentration of the products you are using but in my opinion if you are not contemplating laser treatment you can consider the following:

1. Chemical Peeling — there are various types of peeling available to lighten pigmentation. At my clinic we use a modified TCA peel that lightens the pigment with no downtime.
2. Lightening creams — we use a proprietary blend of hydroquinone, tretinion, and triamcinolone which is like a triple formulation similar to Kligman’s formula.
3. Vitamin C iontophoresis to lighten the hyperpigmentation.

If all these fail, then you can contemplate the laser treatments.

Hope this helps

Dr KK Chew

Hi,

You have post inflammatory hyperpigmentation due to a burn.

Hydroquinone and Arbutin cream seems to be inadequate to lighten your post-inflammatory hyperpigmentation.

A better lightening cream might be Kligman's formula which consists of hydroquinone and 2 other medicines - tretinoin and triamcinolone.

Apart from creams, you might want to consider other treatments:

1. Chemical Peeling — eg. Modified Jessner's peel

2. Laser - eg. Pico Laser

Also, please remember adequate moisturiser and sunblock to avoid darkening of your pigmentation

Hope that this helps!

Warmest regards,

Dr Justin Boey

Hi!

Marks especially burns on legs can last very long. The longest lasting mark that I have seen was scratch marks (from mosquito bites) that lasted 3 years. The best results for topical treatment for burn is those that had been started right after the burn/scabs have healed. A good topical regime to prevent PIH from burns is topical hydroquinone/steroid.

I do recommend scar gel (kelocorte) sometimes. SUNBLOCK is essential to prevent PIH. If you have used your hydroquinone/arbutin topical for more than 2-3 months and the improvement is minimal, you will likely require laser treatment.

We recommend picosure laser toning for such marks/PIH on body. It will require approximately 4-6 treatments to lighten/ remove the mark.

Best regards

Dr Yanni