



using tret + AzA as a spot treatment ?
Almost 2 years ago, I had a very bad abscess on my face that left me with dark post-inflammatory hyperpigmentation and uneven scar texture on my cheek.
At first and after dealing with most of the inflammation (bc i learned one year after that i still had some after all my efforts), I tried to manage it with things like Cicalfate, niacinamide, hyaluronic acid later on, glycolic acid (progressively over the months, not all at once) at some point, and regular sunscreen. Looking back, I wasn’t as knowledgeable about skincare as I am now, so I probably could have made better choices earlier.
Then in December 2025, I made things worse by trying a new vitamin C serum that a derm recommeneded me, while also unfortunately using an expired moisturizer, which ended up causing contact dermatitis / what felt like a mild chemical burn. That left me with more hyperpigmentation under my right eye and near my mouth.
Since March this year, I’ve had 3 laser sessions each month (my last one was in May), and around the time of my first/second sessions I also started trying azelaic acid. I wasn’t able to use it consistently at first because my skin was still too reactive after the contact dermatitis, so I had to stop and restart it a few times. However, I’ve managed to consistently be on Eucerin Anti-Pigment / Thiamidol daily with sunscreen.
Overall, the newer marks under my eye and near my mouth have improved quite a lot, and my skin barrier is now in a much better place. But the original abscess mark on my cheek is still the darkest, slowest to fade, and overall the most stubborn. The texture has improved somewhat, but it’s still not where I want it to be. I’m also planning one last laser session with a more agressive setting to target the texture around August or September.
At this point, regarding the PIH I feel like what I’m missing is something that helps speed up cell turnover, so I’m considering using tretinoin + azelaic acid, but only as a spot treatment on the specific problem areas, since the rest of my skin is actually fine and I don’t want to irritate it unnecessarily.
I don’t plan to make any changes rn as i’m likely to have another laser session but to prepare for the future, my questions are:
- Can tretinoin + azelaic acid realistically be used as a spot treatment for old PIH / scar discoloration?
- Has anyone done this successfully on localized areas only?
- If tret sounds too strong, would something else (tazarotene, adapalene, retinal, or retinol) make more sense as a gentler first step?