Brief Answer: very treatable Detailed Answer: hi. Birth marks can go away completely with lasers or may be greatly improved to the extent of getting unnoticeable. Cream usually don't work on birth marks. Looking at the picture few possibilities come to my mind: 1. Nevus of ota and 2. Cafe au lait macule. 3. pigmentary demarcation line. I would like to know whether its only on one side or is it bilateral?Whats the response to the cream that you have been using and for how long? elaborate a bit about its color, is it brownish or bluish/blackish? A pic or two more would help a lot.. Regards Dr. kakkar

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Brief Answer: Cafe au lait macule on arm,?Demarcation line face Detailed Answer: Hi. The birthmark on arm is definitely 'cafe-au-lait macule'. Its coffee colored or brown in appearance. No cream would clear it ever!!! The one on your face looks a bit dark(bluish/ dark brownish) and it looks more like 'pigmentary demarcation line' which can become prominent after puberty(If you can appreciate it starts from the angle of your eye and and in an V shaped area between your temple and malar prominence, thats exactly how it is on face). There is some additional pigmentation over the demarcation line in the lower part of it which is acquired and it can definitely improve with proper medication But the Pigmentary demarcation line might not go away completely. It has become more promiment because you have been taking Chemical peels+kozimax cream which has made it Stand out even more distinctly. For cafe-au-lait macule: Only laser like Q-switched Nd:YAG laser, Q-switched XXXXXXX Laser, Q-Switched Alexendrite lasers show response though it is variable. The risks of laser surgery include transient hyperpigmentation, hypopigmentation, slight scarring, permanent hyperpigmentation, and recurrence. I would advice that you consult a Dermatologist with Good laser experience in these kinds of lesions. Their is no fixed price. Price depends on the treating doctor and also on the number of session but it would be costly. (i guess anywhere between 20000/- to 30000/-) For superimposed pigmentation on your Pigmenatry demarcation line you can use a triple combination (tretinoin+hydoquinone+tretinoin) cream. Your treating doctor would know about it. Caution: Don't combine it with chemical peels. Use only on the darker area which is on the lower part, use once daily at night along with use of a gel based broad spectrum sunscreen through out the day. I recommend that you consult a dermatologist with all these points in mind which i have told you. I hope i have answered your query. take care dr. kakkar

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Brief Answer: Use medicine s first. Detailed Answer: Hi. Pigmentary demarcation line (dark V shaped area between the temple and malar area) is normal in a few people..In your case you can notice that at the lower part of this V-shaped area it is even more darker..i think that lower part of darker pigmentation is acquired(additional) pigmentation that is superimposed on pre-existing dark area due to demaraction line..it can be made lighter with the use of a triple combination cream (tretinoin+hydoquinone +fluocinolone) in consultation with your treating doctor. I would recommend that you use this cream only on this patch first rather than going for laser. I think it will get significantly lighter if you use this cream for 1-2 months. Yes the side-effects that i mentioned with laser are realistic. Avoiding laser for the cafe-au-lait macule is absolutely justified because in any case it is hidden and not of much cosmetic importance and to add to that i must tell you that at least 10 % of normal populaton has 1 cale-au-lait macule, normally. so its not that uncommon. take care dear. dr. kakkar

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