From the photo, it is difficult to determine for sure, but the primary process might be one of post-inflammatory hyperpigmentation (PIH), i..e. the "footprints" of prior inflammatory folliculitis or simply naturally blotchy, irregular skin pigmentation. In general, so long as there is no accompanying scarring, most postinflammatory pigmentation, like post inflammatory erythema (PIE)--i.e. redness--will fade spontaneously with time. Usually this takes longer on the lower extremities than on the face and longer in people of color than less deeply pigmented individuals. Several weeks to several months are usually required for complete fading (so long as no intervening folliculitis breakouts occur to set the entire process back). Natural, blotchy pigmentation is unlikely to fade by itself.To help speed fading in either case, a series of a variety of in-office superficial peels may be employed, which include low-strength TCA, full strength salicylic acid, Jessners solution and full-strength glycolic acid--all of which I have used for this purpose, either alone or in various combinations. Lemon juice, although in the same alphahydroxy acid family as glycolic acid, is generally too weak to do much of anything. At-home bleaching preparations, which may include hydroquinone in varying concentrations, retinoic acid, arbutin, kojic acid and certain licorice extracts may be used in order to further enhance and expedite the process of fading.The benefits of microdermabrasion, a technnique that at one time was appropriately referred to as epidermabrasion, amount to little more than what may be achieved from a vigorous scrubbing with a Buf Puf, Loofah, or even a washcloth. So, I would not rely upon this nor upon exfoliating soaps to achieve significant improvement.. In fact, overscrubbing and rubbing may even aggravate the problem of overpigmentation. Moreover, I feel that bells and whistles lasers of various kinds and IPL, which are often hyped for treating pigmentatry problems, do little more than add to the expense of treatment. Best to see a board certified aesthetic aesthetic core physician who will be best be able to diagnose and tailor a treatment regimen for you. Good luck to you.
