Scars and discoloration on the legs after infections and skin picking. Treatment options? (photo)

Question

Due to a staphylococcal infection, skin picking and a resulting prurigo, I have many scars and discolorations on my legs. They can be divided into 3 types: - small shiny white spots (partly sunken) - many small red spots - brown and purple discolorations (partly with crusts) Which treatment is most likely to help me get back to my original skin condition? I would give anything for it...

Anna Chacon, MD, FAAD · Answer

Hello,

Thank you for your question. Scarring and discoloration due to infections and skin picking can be challenging to treat, but there are several options that might help improve your skin’s appearance. Here are some potential treatments for the different types of scars and discolorations you described:

Small Shiny White Spots (Partly Sunken):

Fractional Laser Resurfacing: This can help improve the texture and appearance of sunken scars by stimulating collagen production.
Microneedling: This treatment also promotes collagen production and can help improve the appearance of sunken scars.
Dermal Fillers: In some cases, fillers can be used to raise sunken areas to match the surrounding skin.
Small Red Spots:

Pulsed Dye Laser (PDL): This laser targets blood vessels and can help reduce redness and improve the appearance of red spots.
Topical Treatments: Creams containing ingredients like niacinamide, azelaic acid, or vitamin C can help reduce redness over time.
Brown and Purple Discolorations (Partly with Crusts):

Topical Lightening Agents: Creams containing hydroquinone, kojic acid, or retinoids can help lighten hyperpigmentation.
Chemical Peels: Superficial to medium-depth peels can help improve pigmentation and overall skin texture.
Laser Treatments: Q-switched lasers or intense pulsed light (IPL) can help reduce pigmentation.
Additionally, it’s important to address any ongoing issues with skin picking to prevent new scars from forming. Behavioral therapy and certain medications can be helpful in managing this.

I recommend consulting with a board-certified dermatologist who can assess your specific situation and create a personalized treatment plan.

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

Scars and discoloration on the legs after infections and skin picking. Treatment options? (photo)

Answers (2)

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