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Suggest Remedy For Pigmentation On Neck

Posted on Fri, 4 Dec 2015

Question: Hi, I am 24 years old.I have got a dark pigmentation around my neck. I have undergone 4 light chemical peels but it did not make any difference. Also the dermatologist suggested me to use lomella cream for 1 month and later asked me to go for kojimed cream twice a day.I am using suncros spf 26 sunscreen during day time. Even after using lomella for 15 days I don't see any improvements in my pigmentation. Please help me out

Answered by Dr. Nishad BN (2 hours later)

Brief Answer:
Acanthosis nigricans most likely.

Detailed Answer:
Hi

Thank you for asking HCM.

I have gone through your query and pictures. It looks like acanthosis nigricans. This is a skin condition which can be due to any underlying conditions like insulin resistance or thyroid hormone disorders.

Young ladies at your age mostly this problem can be due to polycystic ovarian syndrome in which insulin resistance is more.
Is your periods regular?

Fasting and post prandial blood sugar and insulin test should be conducted. Thyroid function test also should be done.
By correcting the underlying condition you will get improvement to this skin condition.
Kojic acid (kojimed) cream is safe to use. You can continue this and sunscreen. Retinoids and salicylic acid can be used if no improvement. But treating the underlying condition is the main.

Hope this may help you. Let me know if anything not clear.
Thanks.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Nishad BN (5 hours later)

Thanks a lot Doctor.My periods are regular but I have hypothyroidism from past 1 year for which i am already under medication. Recently the dosage was increased as the thyroid level was not coming to normal.

Also would like to know how long it would take for the pigmentation to get cured ?And can you prescribe a better retinoid /salicylic acid based cream?

Along with this I also have acne problem. I am currently using keracnyl facewash and adalene nano gel. Can you suggest some better cream which can reduce acne and also the acne scars?

Answered by Dr. Nishad BN (1 hour later)

Brief Answer:
Polycystic ovarian syndrome should be ruled out by doing ultrsound.

Detailed Answer:
Welcome again.

Thank you for your follow up.

I can see there more action of androgens also in you. This can give acne ,skin darkening and hairfall. So PCOD also should be ruled out. An ultrasound examination of abdomen and pelvis (gynecologic) will be helpful for this. In such case combined oral contraceptive pills and metformin can decrease your acne and pigmentation.

Topical medication you can continue with the current one for acanthosis. Retinoids and salicylic acid/glycolic acid shouldn't be used together. Retinoids can be used at night and should be washed off in the morning. For this adapalene 0.1 % gel or Retin A can be used. Salicylic acid can be used in the morning along with a sunscreen with atleast SPF 30. It can take 6 weeks to 3 months or more to clear.

For acne you can use creams or gels containing benzoyl peroxide and aloe vera to apply at night. Use acne soap for gentle face wash twice daily. Creams containing Kojic acid , vitamin E and vitamin C can be used for acne scars. Available brands are biolite ,Kc lite etc. You can use kojimed also.

Taking vitamin C 100 mg per day and vitamin E for 15 days each month is also good to clear your skin problems. Also take more plain water. Take more citrus fruits. Avoid excess sweets, junks and fatty foods.

Hope this may help you. Let me know if anything not clear.
Thanks.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar