Why have chemical peels not been effective for my hyperpigmentation?

One of the first things your doctor should do during a proper consult would be to take a thorough history from you and examine your skin to assess if you truly have PIH, a combination of PIH and other pigmentary disorders, or a completely different pigmentary condition altogether. PIH can be caused by a wide variety of skin conditions, and it would be important to control the underlying condition too. This may also affect your response to treatments.

If you truly have PIH, current first-line treatment is a medical-grade depigmentation cream, such as hydroquinone, for 8-12 weeks. This cream can be found in many medical and aesthetic clinics. Sunscreen is also a first-line therapy and it’s use should not be forgotten too.

Chemical peels and/or lasers are considered second-line therapy; to be used as adjuncts, with medical-grade creams. There are a wide variety of chemical peeling agents available, in various concentrations. It is important to use a peel suitable for your skin type in an appropriate concentration.

You may want to speak to your doctor about your response to chemical peels so far and see what he/she suggests. I would probably add on a medical-grade topical cream and use a combination of chemical peels and lasers for best results.

Hope this helps!

Regards,

Dr. Joanna Chan

Sorry to hear you are struggling with troublesome post inflammatory hyperpigmentation which often appears as brown marks on the skin after an initial injury/pimple/inflammation on the skin. It is very common in Asians due to the higher melanin content in our skin. which gets released after any inflammation to the area. How long it takes to fade can depend on what caused it in the first place, and the location of the pigmentation. The face will often fade faster than the body, which will fade faster than your legs. Your treatment options are:

1. Medical grade lightening creams containing hydroquinone and retinoids. These are potent lightening creams which help the skin turn over faster as well.

2. Add in lasers to help lighten pigmentation faster if you want a better response.

Do speak to a trusted doctor or dermatologist who can help you further.

Warmest regards

Dr Stephanie Ho, Dermatologist