Skinrepublic

Dear Dr. Jen,

I used to get pimples on my back. Now I am left with plenty of dark scars. What kind of medicine can help fade the scars? Is it safe to use papaya soap and lotion?

June

Dear June,

   Dark acne scars can be such a nuisance. Treatment is fairly simple. It all depends on how fast you want it gone and your budget. The fastest way but most expensive would be laser treatment. Second fastest is doing chemical peels. While the slowest, (we're talking bout a few months here) would be applying bleaching creams over it. There are many OTC creams that contain licorice, tretinoin, kojic acid, arbutin and alpha hydroxyl acids. Hydroquinone used to be the gold standard for bleach but is currently controversial due to its carcinogenicity issue. However, one caveat of buying OTC creams is that they are generally not as strong as compounded medicines. Stronger bleaching agents would have to be prescribed by your PDS dermatologist. 

   Papaya soap and lotions can help up to the extent that it exfoliates your skin. Exfoliation simply involves removal of the dead skin layer (stratum corneum). However, it does not inhibit production of melanin like your other bleaching agents mentioned above. Hope the information I gave you helps!

   Dear Dr. Jen,

   My son has some cream-colored spots on his chest and back. He has tried to get a body scrub several times at the spa but it is still there. He is embarrassed to change his shirt after PE class. What can he apply on it?

   Mommy Sharon

   Dear Sharon,

   There is a fungal infection called "tineaversicolor" that is similar to the condition that your son has. People often get afraid that it might be vitiligo but P. versicolor is quite different in that it is located on sweaty areas of the body like the chest, back, neck and upper arms. It is often off-white in color, versus the chalk white color of vitiligo. It is caused by the fungus Pityrosporum that thrives on areas of the body with increased sebaceous activity.

   In some patients it can even present as red or brown spots. Mostly it is off-white with a white powdery scale. Pityrosporum produces acids that have a toxic effect on melanocytes explaining the white spots on your son's skin. Your PDS dermatologist can diagnose this by scraping a bit of scale and looking at the organism under a microscope.

   Shampoos containing antifungals (ketoconazole, ciclopiroxolamine, selenium sulfide, etc) left for a few minutes on the skin will usually suffice as treatment. The re-pigmenting might take longer but the color will eventually even out. Good luck!

   If you have any questions or concerns please text 0922 845 5556 or email [email protected].

   Dr Tan is a diplomate of Philippine Dermatological Society (PDS). She is affiliated with Perpetual Succour Hospital. For other information on PDS, check http://www.pds.org.ph/.