How to restore color to hypo/depigmented areola after surgery? (Photo)

Question

Question to dermatologists. I had surgery (gyne) 5 mo ago. Left areola had scabs and left whitish depigmented spots (see pic). What cream/ointment can I use to restore pigmentation? Also, the other areola has a nice thin white scar (no pic). Do you recommend silicon gel on that or will it make it whiter?

Alexander Q. Ereso, MD, FACS · Answer

Thanks for your question. Depending on the amount of tissue removed, the size of the incision, and other factors, the nipple areolar complex experiences a decrease in blood flow after surgery. This leads to the formation of eschar (dark, thick scabs) on the skin. I advise patients to allow the skin underneath to heal and to not pick off the scab; rather, to let them fall of on their own. Otherwise, the resulting wound may be open requiring local wound care and occasionally, the skin underneath is depigmented. Regardless, the pigmentation usually comes back, albeit, slowly. Depending on the location, excision of the area is possible however, doing so on you would lead to a visible scar or a change in shape of your areola. Tattooing is possible but obtaining a color match is difficult and I find that the resultant color is more conspicuous than the original depigmented area. The silicone gel will not bleach your scar but may make your scar softer.

Larry Lickstein, MD · Answer

I agree with my colleague that sometimes pigment will return slowly over months.  If it does not, I usually recommend excising the area without pigment, if it can be achieved without distorting the shape of the areola.  While tattooing is theoretically a possibility, it is very difficult to achieve an exact match of pigment.  Best of luck!

Steven Wallach, MD · Answer

I would give the scar a year to heal and soften. Sometimes pigment does come back bit. If it does not, you can always get it tattooed.

How to restore color to hypo/depigmented areola after surgery? (Photo)

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How to restore color to hypo/depigmented areola after surgery? (Photo)

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