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Perineal pigmentation can be corrected with skin lightening creams such as Melarase followed by Melapeels to address pigmentation through exfoliation. Raffy Karamanoukian MD
I would suggest visiting a board certified plastic surgeon in person, to discuss all possible options surgical and non-surgical.Thank you for your question and for sharing your picture!
Thanks for RealSelf question. I might offer fat grafting to fill out these "wrinkled" areas... But best to seek IN PERSON examinations...
As the skin strengthens with your first chemical peel, you will likely have less peeling and dryness with subsequent peels. Best, Dr. Karamanoukian Los Angeles
Blood thinners usually do not interfere with chemical peels. Deep peels such as a high strength TCA or phenol peel may require injections and you may want to hold off on the blood thinners. Best, Dr. Karamanoukian Los Angeles
It is best to review your problems with your skin specialist. Melarase creams can help further improve your skin discoloration and uneven complexion. Best, Dr. Karamanoukian Los Angeles