San Diego Chemical Peel doctors

A chemical peel to a long-standing chemical burn scar is unlikely to be beneficial.  A combination of intralesional cortisone injections and treatment with a vascular laser may be beneficial.  A consultation with a plastic surgeon or dermatologist is suggested.

There is no good chemical or treatment to use on dark skin.  The problem is that anything that can affect the skin can affect the melanocytes that give color to the skin.  Before undergoing any treatment, the skin should be tested in an inconspicuous place to see the effect the treatment.  This is true with all chemicals as well as lasers.

Oftentimes, a combination of treatments will give you the best results. I am a big proponent of laser treatments for the concerns that you've mentioned. You have several options and I'd really have to see you to best guide you in terms of which treatment(s) to choose. However, I will help as best as I can as per your description.

Also, every physician has different opinions as to the pro's and con's of the various treatment options available . . . that's what makes medicine diverse and fun. With that in mind, my discussion below highlights my opinions and I encourage you to talk to as many doctors as you need to in order to feel comfortable in the treatment(s) that you ultimately choose.

For the brown spots, I would recommend treatment with either the IPL (intense pulse light) device, a Q-switched ruby laser, or a Q-switched alexandrite laser. Each of these use specific wavelengths of light to selectively target the melanin pigment (the brown spots are caused by excess melanin being made and deposited in your skin). These treatments also may cause a bit of skin "tightening" (increased collagen production/reorganization), however, in my experience the amount of skin "tightening" from them is minimal.

There are also topical treatments for the brown spots. Products containing hydroquinone slow down the production of brown pigment (melanin) by the pigment producing cells (melanocytes). This is a great treatment option, but, typically takes about two months to show a noticeable improvement. Another topical treatment that would help lighten the brown spots AND tighten the skin (by stimulating collagen production) is a topical vitamin A derivative (retinoid, retinol, etc). There are several other topical creams/lotions/gels that also lighten the brown spots (azeleic acid, vitamin C derivatives, alpha-hydroxy acids, and more). However, those that I have mentioned are the main ones that I recommend to my patients.

Various types of chemical peels are also available to help even out the skin pigment (trichloracetic acid, glycolic acid, salicylic acid, lactic acid, and several more).

For the crepy appearance of your skin, I'd recommend daily use of a topical vitamin A derivative (see description above). This causes more collagen to be produced. As we age, our skin doesn't make as much collagen (nor does it make as much of a substance called "elastin"); also, the collagen and elastin that is produced is not as good in terms of quality as it is in younger people's skin. The combination of these factors result in the skin appearing thin and "crepy". It also causes us to bruise easier (lack of "insulation" around our blood vessels which protects them when we bump into things).

Also, in terms of improving the thickness and elasticity of the skin, I'd recommend considering a series of radiofrequency (+/- infrared) treatments and/or treatment with a fractionated carbon dioxide laser. You will have some down-time with each of these (more so with the fractionated carbon dioxide laser). However, in my opinion, this yields a much better result than some of the non-ablative laser treatments offered right now.

Hope this helps!