lamb - how large and dark are the two discolorations? did your derm diagnose them as solar lentigos, or perhaps something more difficult to treat such as melasma? the treatment options for melasma can be more limited and finicky, as the pigmentation is sensitive to hormones, heat, irritation and anything else that can exacerbate inflammation and then lead to more pigmentation.
For topical treatments, something like Triluma (would require a prescription) would be much more effective than Skinceuticals' discoloration defense. Triluma is a combination of tretinoin, hydroquinone and a topical corticosteroid, and can lighten discolorations quite quickly. It's not meant for indefinite use, however, and your derm will likely recommend discontinuing use once sufficient lightening is achieved and start you on a maintenance regimen (possibly of continuing retinoid usage and/or less risky skin lightening agents, such as vitamin C in the form of ascorbic acid, azelaic acid, etc.). The individual components (tretinoin/other retinoids, hydroquinone) are also effective separately, as are the maintenance treatments (ascorbic acid, azelaic acid, etc.), but their effects are much more effective/faster when used in combination. The limitation is, of course, how much your skin can handle as several of these ingredients can cause irritation/redness/dryness/scaling if you don't build up your usage gradually.
For skin treatments, depending on what the pigmentation is being caused by (as well as skin tone), certain lasers and light treatments (such as the picosure laser as Greg recommends) can be helpful. Again, depending on the size/darkness of the discoloration, as well as overall skin tone, CO2 lasers in the a skilled clinician's hands can be a one-and-done deal to eliminate the hyperpigmentation, but its use is limited in darker skin tones and those with melasma. Superficial (glycolic/lactic/salicylic acids, Jessner's peel, etc.) and medium-depth peels (TCA peels, Obagi blue peel, etc.) are often used with more success on darker skin tones (beware of deeper peels such as phenol if you have a darker skin tone, as there is a risk of hypopigmentation) that are less tolerant of lasers and light treatments (they can cause more pigmentation in these skin tones), but a series of treatments (usually 3+) are usually required, and again the result is often dependent on the clinician's skill and experience.
For melasma, which is probably the most difficult type of hyperpigmentation to treat, oral tranexamic acid is often used with great success, often where lasers/peels/topicals have failed. There is a small risk of thrombosis, so you should take it under the guidance of a physician.
Edited by user Tuesday, December 24, 2019 8:24:38 PM(UTC)
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