I have severe hyperpigmentation on my feet, knees, elbows, and knuckles due to years of crawling. Can a chemical peel help?

Question

I used a very expensive skin lightening cream that only worked on the less course skin. I would like to try a chemical peel on my own I’ve been researching and watching videos of professionals. I noticed that chemical peels for hyperpigmentation is usually done on the face. My case is really rare and I’m currently not financially stable to go to a dermatologist.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Hyperpigmentation of any kind needs a combination approach of peels like Cosmelan; lasers like Clear + Brilliant, Aerolase or Laser Genesis; radiofrequency like Venus Viva; and constant skin care and sun protection. Bimonthly facials with SilkPeel DermalInfusion are essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. If you have acne you can do additional treatments and peels to get more improvement. Hypopigmentation will need more of an evaluation and possibly additional lasers to get improvement. I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

Paul J. Leahy, MD · Answer

Thanks for your question. Yes, treating pigmentation issues on patients with a little bit darker skin color types can be tricky. The treatments can cause worsening symptoms sometimes. I don't think I'd suggest a TCA peel for this particular problem. I really think your money would be best spent w/ a qualified dermatology consultation. Best wishes

Jyoti Gupta, MD · Answer

looking at the pictures, it is difficult to relate this scenario to just friction (crawling). I would suggest you to meet a dermatologist for a correct diagnosis. Cost of consulting a dermatologist would be still less than the unwanted creams and peels. Any chemical working on this much thick skin would be a deeper peel which should be only done under supervisionAll the best

Karthik Ram, MRCS, DNB · Answer

Hi, Chemical peels does wonders, but it is safe doing under medical supervision. I advise you to meet a board certified dermatologist or a cosmetic surgeon to rule out the root cause of hyperpigmentation and then to treat it holistically. Chemical peel alone wont work, you need to use certain skin lightening creams to maintain it which are economical and at the same time effective also. Hope this will help.

I have severe hyperpigmentation on my feet, knees, elbows, and knuckles due to years of crawling. Can a chemical peel help?

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