Question about hypopigmentation treatment

Question

I have an acne scar that loss pigmentation after a sunburn. I was wondering if there are any treatments for hypopigmented scars. The scar is about the size of a dime on my forhead.

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about your concerns with hypopigmentation. Hypopigmented scars, particularly those that result from acne and subsequent sunburn, can be challenging to treat, but there are several options you might consider. It's important to consult with a dermatologist to determine the best approach for your specific case. Here are some treatments that are commonly used for hypopigmented scars:

1. **Topical Treatments:**
   - **Corticosteroids:** Topical corticosteroids can sometimes help to reduce inflammation and promote repigmentation.
   - **Tacrolimus or Pimecrolimus:** These are immunomodulating agents that might help in some cases of hypopigmentation.
   - **Retinoids:** Topical retinoids (like tretinoin) can help in skin turnover and might improve the appearance of scars over time.

2. **Laser Therapy:**
   - **Fractional Laser Resurfacing:** This can help to stimulate collagen production and may improve both the texture and pigmentation of the scar.
   - **Excimer Laser:** This type of laser can target hypopigmented areas and stimulate melanocytes (the cells that produce pigment).

3. **Microneedling:**
   - Microneedling involves using fine needles to create micro-injuries in the skin, which can stimulate collagen production and sometimes improve pigmentation.

4. **Chemical Peels:**
   - Superficial chemical peels can help to promote skin turnover and may improve the appearance of both the texture and pigmentation of the scar.

5. **Platelet-Rich Plasma (PRP) Therapy:**
   - PRP involves injecting your own platelet-rich plasma into the scar to promote healing and regeneration, which might help with pigmentation.

6. **Camouflage Makeup:**
   - While not a treatment, high-quality camouflage makeup can effectively cover hypopigmented areas and improve cosmetic appearance.

7. **Sun Protection:**
   - Protecting the scar from further sun exposure is crucial. Use a broad-spectrum sunscreen with an SPF of 30 or higher, and consider wearing hats or other protective clothing to prevent further damage.

8. **Depigmenting Agents:**
   - In some cases, your dermatologist may suggest using depigmenting agents on the surrounding skin to make the hypopigmented area less noticeable.

Each of these treatments has its benefits and potential risks, and the effectiveness can vary depending on the individual and the specific characteristics of the scar. It's essential to have a thorough discussion with a dermatologist to tailor the treatment to your needs and ensure that you understand the potential outcomes and any associated risks.

Joseph Mlakar, MD · Answer

Good Morning ! I would recommend seeking an esthetician to help with different treatments of pigmentation issues. Have a good day

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
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. Yes, there are several treatments available for hypopigmented scars, which are scars that have lost pigmentation and appear lighter than the surrounding skin. Here are some common approaches:

1. Topical Treatments
Hydroquinone: A skin-lightening agent that can help reduce pigmentation differences.
Tretinoin: A retinoid that can promote skin cell turnover and improve pigmentation.
Vitamin C: An antioxidant that can help brighten the skin and even out pigmentation.

2. Chemical Peels
Purpose: Chemical peels involve applying a chemical solution to the skin to remove the outer layers and promote new skin growth.
Types: Mild peels (like glycolic acid) or stronger peels (like trichloroacetic acid) can be used, depending on the severity of the hypopigmentation.

3. Laser Therapy
Fractional Lasers: These lasers can stimulate collagen production and help blend the hypopigmented scar with surrounding skin.
Intense Pulsed Light (IPL): IPL can target pigmentation issues and improve skin tone.

4. Microneedling
Purpose: Microneedling involves using fine needles to create micro-injuries in the skin, which can stimulate collagen production and improve skin texture and pigmentation.

5. Sun Protection
Purpose: Protecting your skin from sun exposure is crucial, as UV rays can worsen pigmentation issues. Using broad-spectrum sunscreen daily can help prevent further changes.

I hope this helps and best of luck!

Guilherme Szerman, MD · Answer

There is no fully approved treatment to darken white spots, but the CO2 laser may offer some results.

Question about hypopigmentation treatment

Answers (5)

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