Brown spots – what more can I do?

Hi Dr. Irwin- I wanted to ask you about post-inflammatory hyperpigmentation. My skin is pretty even overall, but I have a few darker spots from some acne I had two years ago. I have used both over-the-counter and prescription retinol products since then, and am very religious about sunscreen, but they just aren't going away. I was hopeful when I read about Elure, but would like professional advice. What do you think is the best treatment for these types of dark spots?

This is such a vexing problem for both patients and doctors because there’s no one perfect solution that fits everyone and …… in some cases, there really is no cure, just good control.

I’m assuming from what you wrote you want to try something else in a cream/topical first.  Triluma, which is currently not being manufactured, was based on a combination developed by a Dr. Kligman and was called the Kligman formula.  It was a combination of hydroquinone 4%, a mild steroid (anti inflammatory), and tretinoin (Retin A/Renova etc).  It is sometimes also referred to as “triple cream.”   This combination worked well.  Most people noted significant improvement with this product when used for 3 months.  More on pigment.

Dermatologists can usually get this formula made as a custom formulation by a compounding pharmacy.  In my opinion, the Elure will probably do nothing.  Consider seeing your dermatologist and getting the triple cream by prescription.   Hope this helps,  Dr. I 

Dr. Brandith Irwin, MD

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