Treating hyperpigmentation and deep neck creases - advice? (photos)

Question

I have hyperpigmentation on my neck that has a stark contrast from the color of my skin where my hairline starts. I'm bald and shave my head, so I can't hide the skin under my hair. The contrast, blotchy color and the deep creases in my neck really bother me. I would love this skin to be smoother in color and texture. I've tried Halo, but am not seeing a major difference in the texture or color of the back of my neck. Would love recommendations for treatment and upkeep. Thank you!

Nelson Lee Novick, MD · Answer

Treating the deep neck creases in order to elevate and smooth them is relatively easy with an appropriate HA filler injected with the proper injection technique. The hyperpigmentation is another story. It is very difficult to determine from the photos, but this dyspigmentation could result from chronic sun damage or may even be a manifestation of another condition, known as acanthosis nigricans, which commonly affects the neck and imparts a velvety feel to the skin and can be associated with insulin resistance and even diabetes. You would be wise to consult a board certified dermatologist first to establish the correct diagnosis before merely jumping from one expensive "bells and whistles" device treatment to the next. Hope this helps and best of luck

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Treating hyperpigmentation and deep neck creases - advice? (photos)

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Treating hyperpigmentation and deep neck creases - advice? (photos)

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