Dark Knuckles From Punching Bags; What Percent TCA Peel Do you Recommend?

I have brown skin.I prepare the area with 3% hydroquinone every morning, and a mixture of retin-a .05%, hydroquinone 3% and hydrocortisone 1% at night with little lightening. I plan to do a tca peel after a month of the above is finished, and was told to use the 20 % because anything stronger takes longer for the skin to flake off. My skin is very resistant to peeling(does not peel with retin-a combo or mild peels.) Please help, im lost where to start.

Doctor Answers 1

You may need more than a TCA peel!

You mention darkening of your knuckles after punching bags. So, is the skin over your knuckles thick as well? In which case, you may be having hyperkeratosis (thickened skin resulting from friction/ shear stress) which needs to be considered in addition to the hyperpigmentation (darkening) that you are concerned about. If there is, indeed, thickening you can try salicylic acid creams starting from 6%, going  up to 12% at bedtime. Once the thickening lessens, then lightening creams have a better chance. 

A very good plan would be to consult your doctor first, so that your treatments/ creams may be optimized to give you good results in a reasonable span of time!

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