Dark spot

Dear Dr Jen,

I had shingles many months ago. Up to now, the dark spot is still there. Will this scar remain forever?  Are shingles scars harder to lighten?

Cori

Dear Cori,

There is no need to panic.  This is no different from other kind of scars from shallow wounds or from acne. Post-inflammatory hyperpigmentation (PIH) from shingles is very much treatable with gentle bleaching creams.  Safe active ingredients to look for are vitamin C or a mild retinol.  This may take a few days to a few weeks depending on how fast your skin responds to the medicine. Bleaching soaps will not help.  Acid-containing (salicylic acid) solutions may dry and irritate skin.  Make sure to visit your PDS dermatologist to get the appropriate prescription medicine to brighten your scar.

Pockmarks from shingles, however, are a different story.  These are excavated or depressed spots usually arising from vesicles that were scratched or that became infected.  Fractional laser may help in making the marks more shallow but this is over several sessions.  Hope this answers your question.

* * *

Dear Dr. Jen,

I keep getting white heads on my face.  What medicine can I use to make it go away for good?  These are removed when I get facials but I seem to be coming up with new ones all the time.

Juliet

Dear Juliet,

Whiteheads are small bumps on the skin composed of trapped oil and dirt.  The evolution of closed comedones result from pores that have been blocked by skin debris, dirt or facial products.

There are multiple factors to take into account.  If puberty, hormones or medication are not factors to consider, review your facial regimen, especially your cleanser and moisturizer.  There are ingredients that can cause over production of oil or those that are simply comedogenic (or whitehead-producing).

Left untreated, whiteheads may become a full blown pimple or acne vulgaris. Application of creams that contain alpha hydroxyl acids, retinoic acids, lactic acid or glycolic acid can help slough off the skin covering the pore, unblocking your whiteheads.  Yes, simple use of the right medicine can remove those whiteheads.  No need for a weekly facial.  However, if your whiteheads are already mixed in with some pimples, a more complex treatment may be necessary.  Topical antibiotics will be needed.

Facials, especially when performed by an untrained doctor, can result in more whiteheads.  Firstly, the products being used on your face can aggravate and worsen comedones.    Secondly, the oil may be pushed deeper into the skin.  If acne surgery is to be performed, have a PDS derma perform it, to make sure no scarring happens and your condition is properly addressed.