Dark/raised scarring on lower back/buttocks after illness - will a chemical peel help or would laser be the best option? (Photo)

Thank you for sharing your detailed history — it sounds like you’ve been through quite a challenging experience. The type of rash you described following your illness and medications likely triggered an inflammatory response in the skin that’s now healing with post-inflammatory hyperpigmentation and textural scarring. The fact that some areas are slightly raised suggests residual inflammation or a mild hypertrophic healing pattern rather than active acne.

You’ve already done well by incorporating tretinoin and gentle exfoliating agents like salicylic acid, as these help encourage skin cell turnover and fade discoloration over time. However, because the buttocks and lower back have thicker skin and heal more slowly than the face, improvement can take several months.

When it comes to next steps:

Chemical peels can indeed help smooth and lighten the scars, particularly medium-depth peels that target both pigmentation and texture. A series of peels spaced a few weeks apart tends to yield the best results.

Laser treatments, especially fractional or resurfacing lasers, may be more effective if the scarring is raised or texturally uneven. These treatments help remodel collagen and flatten out any residual thickening while improving pigmentation.

A balanced approach often works best — for example, continuing your topical routine while undergoing periodic in-office treatments such as peels or light-based therapy.

While this process can be gradual, consistency really pays off. The good news is that these scars tend to respond quite well to treatment once inflammation fully subsides.