Two year old acne hyperpigmentation. (photos)

I have hyper-pigmentation for almost two years and it lightened just a little bit.Can you please suggest some topical creams for that and also would hydroquonine be effective for these marks as they are more red in color rather than brown... Thanks

Doctor Answers 4

Pico lasers is ideal in this case.

Acne scar revision is a specialised field. For the best results, one should target the acne scar type with ideal treatments. For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgery. In your case, if can find a specialist who can perform both TCA CROSS for the deeper scars, then finish off the treatments with PICOSURE Focus or even Picoway, this would be ideal (for the Pico lasers, they can reduce pigment, and should be done at the end). 2-3 sessions. More on this in the video link below. 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars.

All the best,

Dr Davin Lim.

Laser, surgical & aesthetic dermatologist.

Brisbane, Australia.


Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

Two year old acne hyperpigmentation

Thank you for the photos. Yes hydroquonine will help with the dark hyperpimentatiion and a series of chemical peels/ microdermabrasions with the process go faster. The redness might be best treated with a VPL light reatment. Be sure while doing these treatments that you use sun protection. I wish you luck!

Bruce K. Smith, MD
Houston Plastic Surgeon
4.4 out of 5 stars 8 reviews

Acne scarring approaches

When deciding how to improve acne scars (or any type of scar), I assess both the discoloration and the texture. In your case, the scars are mostly red, which is best treated by a pulsed-dye laser such as the VBeam Perfecta. You would likely need a few treatments. This would also help a bit with the texture of your skin. However, if your priority is to get the smoothest skin possible, you would be best served by getting a series of fractional resurfacing laser treatments. The best laser would be the Fraxel Dual laser, using the 1550 setting. 

Wendy Long Mitchell, MD
New York Dermatologic Surgeon

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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.