Thigh lift scar colouring. What are my treatment options? (Photo)

Question

I had a thigh lift about 6 years ago. The groin area spilt post surgery resulting in restitching. This result in a blood like stain or pigmententation. What treat options are there in terms of perhaps laser or creams. The rest of scar is white and good.

Anna Chacon, MD, FAAD · Answer

Thank you for your question and for sharing your experience.

Scarring in the groin area after a thigh lift—especially when healing was complicated by wound separation and re-suturing—can result in hyperpigmentation or a "blood-like stain" appearance due to post-inflammatory hyperpigmentation (PIH) or hemosiderin deposition.

Treatment Options:
1. Topical Lightening Agents
These are typically first-line treatments for pigment changes:

Hydroquinone (2–4%): A skin-lightening agent that reduces melanin production.

Tretinoin: Enhances cell turnover and may fade pigmentation over time.

Azelaic acid, kojic acid, or niacinamide: Gentle options for sensitive areas like the groin.

Cysteamine cream: A newer depigmenting agent with fewer side effects.

These should be applied carefully in the groin area under medical supervision due to skin sensitivity.

2. Laser Therapy
Fractional lasers (e.g., Fraxel): Help with texture and pigmentation.

PicoSure or Q-switched lasers: Specifically target pigment and may break down blood-related discoloration (e.g., hemosiderin).

Vascular lasers: If the discoloration is related to persistent blood vessels.

Laser choice depends on the exact pigment type and your skin tone—darker skin types require more caution due to risk of rebound hyperpigmentation.

3. Microneedling with PRP or Topicals
Microneedling can remodel scar tissue and improve pigment distribution. When combined with platelet-rich plasma (PRP) or pigment-lightening serums, results are enhanced.

4. Silicone Gels or Sheets
While more effective in early scarring, these may still help with overall scar texture and healing environment, which can slightly improve discoloration.

Final Notes:
Since the rest of your scar has healed well and is now white, the isolated pigment may respond well to a targeted approach. I recommend starting conservatively with topicals, then exploring laser options under the care of a board-certified dermatologist with experience treating post-surgical scarring in sensitive or high-friction areas like the groin.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For the pigmentation and discoloration in the groin area resulting from your thigh lift, CO2 laser resurfacing could be an effective treatment option. This procedure uses a focused laser to target and remove the outer layers of damaged skin, promoting new skin growth and stimulating collagen production. CO2 laser resurfacing is particularly beneficial for improving skin texture and reducing pigmentation irregularities, which can help blend the discolored area with the surrounding skin. I hope this helps and best of luck!

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