Which is better TCA spot peel QS Laser (3) OR by topical method to treat the brown PIH. (photos)

I am 29 years old male having a PIH and scar on my right cheek due to bike accident 8 months back. I've consulted a skin specialist and the Doctor advises me to under go Frac CO2 laser, TCA spot peel QS Laser (3). Does that mean I will have to undergo both those treatment at the same time and will those treatment be able to completely fade away the scar as well as the brown PIH that has developed on my cheek. OR can this Brown PIH be cured by topical method?. Thank you for your time. (Picture attached)

Doctor Answers 1

Hyperpigmented scar after trauma

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Thank you for asking about your right facial hyperpigmented scar.

  • Judging by your photo, you seem to have had a 'road burn' injury over you right cheek bone, with skin thinned in the center and hyperpigmentation around it.
  • The central scarring cannot be removed - scars are permanent damage to the skin. 
  • I assume your doctor intends the Fraxel to make the scar smoother and the TCA sot peel and Q-switch laser to fade the color.
  • Although these may be effective, I would consider it essential to pre-treat the skin with skin lightener and tretinoin (generic Retin A) so that these treatments don't themselves cause more hyper-pigmentation.
  • If these pre-treatments fat\de the brown color - they are not likely to do so but it can happen - then you may not need the others.
  • You might first try 100% cocoa or shea butter on the damaged skin - I have many patients who say this fades skin discoloration that prescription treatments failed to improve.
  • Be sure you know from your doctor exactly what the purpose and sequence is of each treatment - and be sure to ask for skin pretreatment. 

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.