What is the best scar removal cream for black spots on the legs?

Hi Jebrain.  For the type of scar that you show in the picture, we would use one or two options.  Hydroquionone bleaching creams and/or q-switched Nd:Yg laser treatments.  Visit the link below and you will be able to read an article we wrote (and see pictures of) a patient that had bug bite scars on her legs and was able to wear a dress for the first time in years after visiting our office.

I would highly recommend using Vitamin C serum every morning to dark spots as well as using Hydroquinone creams or pads every night. You may also begin treatments such as JetPeel which infuses glycolic acid as well as brightening vitamins to affected areas. You can also treat with lasers such as RadioFrequency Skin Resurfacing due to skin type. 

Thank you for your question and your photos. Based on your photos provided, I would recommend hydroquinone bleaching to treat these spots as well as various laser procedures that can be done. Please consult with a board certified physician.

Unfortunately the brown spots on legs from injury, bug bites, infected hair follicles, eczema etc., that have been there for years often allows the pigment granules to drop deeper in the dermal layer below the epidermis making it difficult or impossible for lightening creams to improve them. Some lasers have been effective in a few individuals to make these spots better, but very often, the lasers themselves darken the skin more because of the patient's own tendency to hyperpigment (darker skin developing in areas of inflammation or trauma). Lightening creams will often be used in advance of the laser treatment and I recommend a test spot to be done prior to treating the whole leg to see how the particular's patients skin will respond. The lasers I have used to treat hyperpigmentation have included q-switched ruby laser, Neodynium-yag laser, picosure laser focus mode, Clear & Brilliant Permea and even the V-beam laser (sometimes there is an element of redness in the dark color). 

I see this condition very often in patients with Olive or Black skin. I perform chemical peels in the area and combine the regimen with topical cream treatments. The results are effective. I would use Melarase twice daily for the hyperpigmentation.The development of dark spots on the legs post insect bites is known as PIH, or post inflammatory hyperpigmentation. This results in an overstimulation of pigment granules that often get trapped within the dermis of the skin. In my practice, I use the Melarase creams (Melarase AM and Melarase PM) because they can decrease the rate of production of abnormal melanin and enhance exfoliation of existing melanin. Melarase AM contains four active sunblocks + skin lighteners.  Whereas, Melarase PM contains HQ and natural skin lighteners with an exfoliant.  The process will take some time, but is highly effective. Luminase and Exfolase are excellent for dark scars on larger areas. Best, Dr. Karamanoukian#Realself100 Surgeon

Post-inflammatory hyperpigmentation on legs is a common and problematic skin condition that affects disaproportionately individuals of ethnic skin color. While the mainstay therapy would be a combination of bleaching cream, retinoid cream, glycolic acid or vitamin C as prescribed and supervised by a board-certified dermatologist, it is critical that you #1 minimize further trauma in affected area, #2 achieve strict daily sun protection with sunscreen and sun protective clothing, #3 leg elevation when possible to improve circulation, and #4 frequent application of emollient/moisturizer, particularly after shower.

Thank you for sharing. Based on the image provided, these appear to be hyperpigmented spots, not scars. Depending on your skin type, there are also chemical peels
or laser treatments that have a very high success rate in treating
hyperpigmentation. We have the Fraxel laser and the Picoway laser which target
pigmentation and work to eliminate it in a series of treatments. Chemical
peels contain glycolic acid, retin-a, arbutase, and other chemicals which work
to lighten the skin. They are both very effective treatments. It is important to see a board certified dermatologist for an in person consultation. Thank you for your question and best of luck!

Thank you for your post. Scar related hyperpigmentation can be reduced with Plato's Dark Scar Corrector or Sclerovase. Both can be found on VenaSmart (see link below). H Karamanoukian MD FACS

I would recommend Hydroquinone %4 to be applied once a day until the desired effect is seen. This cream is basically a "bleaching" agent that is very effect for these dark areas. Please consult with a board certified plastic surgeon.

Thanks for your question and thanks for including the photo as well. The photo shows what we describe as post-inflammatory hyperpigmentation or PIH and it is important to have an evaluation with a board-certified dermatologist to try to figure why these developed in the first place so that issue can be handled appropriately. To actually treat the PIH in this area, we would recommend one of the really good bleaching medicines on this, including those with hydroquinone. If one recommends a laser, perhaps a Q-Switch laser would be effective on the legs, but caution needs to be given here as legs and lasers respond differently in many than many when we treat this with lasers on the face. Again, consult with the right provider to have this concern addressed.