Brief Answer: "Steroid Abuse" or "Steroid dependence" Detailed Answer: Hello, Welcome and thanks for posting your query to the forum. I can understand the concern for dark skin. After reading your query it can make out that you have applied Panderm plus cream for long time. The findings which I can get from your query makes the diagnosis of "Steroid Abuse" or "Steroid dependence". "Steroid Abuse" or "Steroid dependence" is quite common phenomenon where after long term, injudicious and unregistered use of steroid creams without medical advice lead to the multiple side effects. Topical steroid creams are potentially known to cause side effects on long term or injudicious use in form of thinning of skin, hair growth on affected area and prominence of vessels with rashes. In your case you have applied panderm which contains Clobetasol in it. This is a strong potency steroid and is never to be used on face. If at all is used on other parts too then also not beyond 15 days. I very often see person of your age using this cream and damaging the skin. Once it is started on face it initially gives fair complexion. This is because of mild stoppage of the activity of color producing cells. SO it gives initial fair complexion. But on regular usage it produces skin atrophy and then dependence on it. It is a must to stop the cream at the earliest. For the betterment you need to meet a dermatologist who can take off the steroidal side effects slowly with different medications. You need to have patience of multiple months to get off from the situation. It would be best to send few good resolution pictures of the face area so that it can be analyzed best. You have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your queries better. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia- Query Id : Query Id : 96920). If I were your dermatologist then to take off the side effect and making the skin lighter again I would have prescribed tacrolimus 0.1 % ointment in day time and Kojic acid cream at night time only over the affected area. Apply it in such a thin layer that it should not be visible by naked eye. Do not try to rub it. It is generally diluted with some bland cream to reduce the irritation. So these creams are to be used under dermatological guidance only. Hope these informations will help you. If you have any further query I will be happy to help. Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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