How do I fix post inflammatory hyperpigmentation and boil scars left behind from boils skin infection? (Under breast, groin)

Question

Hello, I’m 32 y o,f5’obese. I had a rapid weight gain of a hundred pounds in a three year period due to medications and lifestyle factors. I developed autoimmune issues and the fast weight gain also led to more skin folds. I developed a longterm boils infection under my breasts and groin area. I’m on the AIP didt now and am steadily losing the weight and meds changes has helped also. That along with topical interventions have contained the infection and im left with these dark scars and pits.

Anna Chacon, MD, FAAD · Answer

Addressing post-inflammatory hyperpigmentation (PIH) and scarring from boils can be challenging, but there are several strategies that may help improve the appearance of your skin:

Topical Treatments:

Hydroquinone: This is a common treatment for hyperpigmentation. It works by lightening dark areas of the skin.
Retinoids: Prescription-strength retinoids can promote cell turnover and improve pigmentation and texture.
Vitamin C: Topical vitamin C can help brighten the skin and reduce pigmentation.
Azelaic Acid: This is effective for both acne and PIH, helping to even out skin tone.
Chemical Peels: Superficial chemical peels can help exfoliate the skin, improve texture, and reduce hyperpigmentation. Glycolic acid and salicylic acid peels are commonly used.

Laser Treatments: Laser therapy, such as fractional laser or intense pulsed light (IPL), can be effective in reducing pigmentation and improving skin texture.

Microneedling: This procedure can improve the appearance of scars and hyperpigmentation by promoting collagen production and skin regeneration.

Scar Treatments: Silicone gel or sheets can help flatten and fade scars over time.

Professional Consultation: It's essential to consult with a dermatologist to tailor a treatment plan to your specific needs, especially considering your history of autoimmune issues and recent lifestyle changes.

Sun Protection: Protecting the affected areas from sun exposure with a broad-spectrum sunscreen can prevent further darkening of the scars and hyperpigmentation.

Continued Weight Management: As you continue with your weight loss and lifestyle adjustments, the reduction in skin folds may also help prevent further infections and improve overall skin health.

Each of these treatments can have different effects depending on individual skin types and conditions, so a personalized approach is recommended.

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

How do I fix post inflammatory hyperpigmentation and boil scars left behind from boils skin infection? (Under breast, groin)

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