Home peels but nothing is reducing hyper-pigmented hard rough skin on knees. Are there any treatments that will help? (Photos)

Question

I’ve been doing home peels 70% glycolic, I’ve tried lactic acid, I’ve tried peeling gels. The skin is still very rough and thick, it doesn’t reduce even after 4 Montbs of consistent peels. I’ve also tried 40% Urea cream nightly. Are there any treatments in London that can remove this tough skin and lighten it? It wasn’t like this before, I've been on my knees a lot fixing things and looking after baby who’s crawling. Any lasers, peels that I should be doing?

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

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed question and the effort you've already put into treating the condition. It sounds like you’re dealing with a combination of post-inflammatory hyperpigmentation, lichenification (thickened skin from friction/pressure), and possibly frictional melanosis, which is especially common on areas like the knees.

David Hansen, MD · Answer

Glycolic acids aren’t strong enough for most hyperpigmentation problems. Especially knees which need 25-35 % TCA peels and usually 1-3 At monthly intervals.

Home peels but nothing is reducing hyper-pigmented hard rough skin on knees. Are there any treatments that will help? (Photos)

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