Brief Answer:
Combination of modalities will be ideal

Detailed Answer:
Hello My Dear

Welcome to the portal and thanks for writing in!

I am Dr V XXXXXXX a Sr Dermatologist. I will be glad to help you deal with the problem.

I see a very large number of patients in my practice with similar complaints and profile matching yours. I have looked into your concerns.

If you were to attend with me in person, I would have suggested the following measures. In fact these are multiple measures which are likely to work in conjunction with each other to provide superior results:

1 Avoid sun exposure as much as possible. It would be ideal to use a sunscreen of SPF at least 35 at least twice a day 1100and 1300 hrs, everyday, irrespective of climate and being indoors

2 Use Tretinoin 0.025% for 1-3 hours daily evening, beginning with low duration initially and in the mornings use Clearz Plus Gel, a Kojic acid preparation

3 Oral antioxidants

4 Glycolic acid peels with gradually increasing concentration a few weeks after priming with Tretinoin has been achieved

5 If faster results are the aim, one can consider Laser resurfacing.

Depending upon your personal requirements, you can take a good decision to how to deal with the issue for best results.

I assume that you have not been taking any medication like hormonal preparation that could influence development of these patches.

Wishing you the best of health and you may contact me again for any queries.

Thanks

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Brief Answer:
Names might vary depending on loaction

Detailed Answer:
Dear Sir

Thanks for being with us again.

Here is the required information. The brand names might be different in your geographical location. Your doctor or pharmacist will be knowing the local names.

Tretinoin is available as Retino-A

Clearz Plus is the Kojic acid preparation

Oral antioxidants can be had from fresh fruits and vegetables as well as in medicinal preparations like Antoxid-HC

Sunscreens are mostly OTC preparations to the best of my knowledge and what matters most is their SPF rather than the brand name.

I hope you will find this information useful
In case you are not able to locate them in your area, you please send me links to local pharmacy websites and I will go though their stocked medicine list and select the ones for you.
Best wishes

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