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Q. How to treat old dark scars in legs?

Answered by
Dr. Sidharth Sonthalia
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 09, 2020

Hello doctor,

I have some scars on my legs from when I was a younger kid. So when I was younger I fell and bruised and got scars. Sometimes, I would scratch my scars and over time the scars become dark and they look ugly. And since then I do not wear shorts or clothes that show my legs. Is there anything I could try to fade the scars or lighten them?

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Hello,

Welcome to icliniq.com.

First of all, your scratching induced issues over the skin are not scars, rather they are marks that too over a background of another mild skin condition that you seem to have. Scars are aberrations in the skin texture, irrespective of the color change.

What you have is: Background of a mild skin condition called macular amyloidosis (MA), you may see light brown colored speckled pigmentation in coalescing patches over your leg shins. These arise spontaneously, mostly without any cause, although friction contributes to it in terms of making it worsen and darker. So, do not scratch any further.

Few marks, these are the smaller spot-like darker brown colored discrete and are a few in number, a result of the healing of the skin over your pointed scratched areas.

Now MA does not have a permanent treatment and also often does not need it. It may also affect the upper back and upper arms, just have a look. Sometimes, it tends to run in families. Moisturization with Cetaphil dam lotion after bath and before sleeping tends to reduce the associated dryness, itching as well as roughness of those areas. But many times, especially in girls and women, MA is associated with thyroid dysfunction. So, please get your serum TSH (thyroid-stimulating hormone) blood test done.

For the brown marks that are bothering you, you will require a depigmenting cream to be applied in the night just over the spots and a broad-spectrum sunscreen with SPF 50+ (sun protection factor) in the day time on the entire legs daily. I believe Cetaphil UVA/UVB sunscreen or Anthelios-XL (SPF-60) or Avene sunscreens may be available to you over the counter. Use them daily over the entire legs and first coat to be applied at least half an hour before going out.

Now, I would not be able to tell you which depigmenting (skin lightening creams) are available in your place. But, you can check with your local pharmacist. You could select from a range of combination creams that often contain varying proportions of Hydroquinone, Kojic acid, Glycolic acid, Arbutin, Azelaic acid, mild steroid, Tretinoin, Vitamin C or E, etc. Although it would be ideal that you get a prescription cream from your dermatologist, till then you may (for the short time 15-30 days only) use one of these creams, to be used as spot therapy only over the dark spots, in minuscule quantities, that too strictly at night and discontinue using it if it causes excessive redness, peeling, irritation, etc.

Additionally, take some good oral anti-oxidant capsule daily for two to three months. For best management, please revert back with the answers to my following queries:

Do you have similar pigmentation over the back? Please send pictures in your response. Does your mother or other family members have a similar problem? Get your serum TSH levels checked and let us know the value.

Contact the pharmacist and try to procure and use the sunscreen and night cream. In your response, please tell us the brand that you procured and the contents of the skin whitening cream so that we could further advise you about its use and safety.

I hope this helps.


Investigations to be done:

Serum TSH levels. Blood test to be given in a fasting state.


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