instruction: 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
output: 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 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 thyearoid dysfunction so please get your serum ash thyearoid stimulating hormone blood test done for the brown marks that are bothering you will require a depigmenting cream to be applied in the night just over the spots and a broad spectrum sunscreen with spy 50 sun protection factor in the day time on the entire legs daily I believe cetaphil uva uv sunscreen or anthelios xl spy 60 or avenge sunscreen 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 koji acid glycolic acid arbutin azelaic acid mild steroid tretinoin vitamin or 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 ash 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 serum ash levels blood test to be given in a fasting state