What's a good acne/melasma treatment for someone who uses tretinoin and is prone to PIH? (photo)

Also want to address minor acne scars? I've been using tretinoin .05% for 5 months now & the effects are starting to plateau so I was considering a peel or microderm, but I'm very scared to do anything that could exacerbate pigmentation problems, because I get PIH very easily. If I want to do a light peel, what is the safest kind? Would a microderm be less risky? I'm 1/2 se asian 1/2 caucasian between a fitzpatrick type 3 & 4 (I tan very easily and get very dark, but face and unexposed skin is quite fair).

Doctor Answers 2

Acne and brown spots do well with the Spot Peel, even in patients of asian background

This is a common problem in my practice, where I treat many asian or asian/caucasian patients with your skin type. For this combination of problems in asian skin, I have tried Refinity peels (70% glycolic acid with and antiinflammatory ingredient strontium nitrate to prevent stinging, redness, peeling and postinflammatory hyperpigmentation) and physicians'-model (stronger than what can be sold to aestheticians) microdermabrasions, as well as topicals such as Retinol with green tea polyphenols, coffeeberry creams and 10 % L-ascorbic acid (vitamin C) cream.  But what has been most effective has been the Spot Peel by Dermaceutic.

The problem with melasma is that it will come right back if you get even brief sun exposure after clearance, so patients need to using a specifically-formulated vitamin C cream with a low pH, on clean skin, left on for at least an hour, every few days if not daily, to prevent recurrence.

New York Dermatologist
5.0 out of 5 stars 8 reviews

Re: Treatment For Acne/Melasma

I always like to recommend that patients understand how and why certain treatments work. The causal factors of acne and melasma lie beneath the skin’s surface. With acne, this often includes high rates of skin cell turnover within the skin pores which develop into blockages. Melasma is caused by high levels of melanin being produced. This is caused by a combination of sun exposure and hormonal changes.

A laser system like Fraxel Dual is safe for all ethnic skin types. The energy used is targeted and will not be absorbed by the melanin which naturally colors your skin (thereby causing overheating). It will safely destroy cells which produce and store pigment . This clears the complexion.

Spectra is also safe for all skin types. And it will address multiple deep level causes of acne.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

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.