Brief Answer:
Kinldy elaborate query and send pictures.

Detailed Answer:
Hello XXXXXXX

Welcome and thanks for posting your query to the forum.

I can understand your concern for sun burn mark on face at right cheek and on forehead as well as the related effects of the same.

In view to help you best I humbly request you to kindly elaborate your concern in terms of certain important things:

- Since how long you have the sun burn mark.

- Did the mark appeared gradually or suddenly.

- Do you feel any burning or itching over same. If yes then grade -mild/moderate/severe.

- Any other symptom felt by you on the mark.

- Since how long you are using Melalong cream.

- Tell me about occupation with your daily routine including your diet, exposure to sunlight or computers.

- Any history of smoking or alcohol.

I also request you to upload good resolution pictures of the affected ares. It is utmost important to diagnose the exact entity. You can upload the report by utilizing our service. For that you have a feature to upload images of the reports by yourself at the right side of the query page. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia.

"Wish you good health"

Regards,

Dr Sanjay Kumar Kanodia
MD (Dermatology)

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Brief Answer:
Sun protection; reduce weight and medications

Detailed Answer:
Hello,

Welcome again and thanks for posting additional informations as well as the good resolution pictures.

After getting additional informations and analyzing the pictures I can make out that you have quite deep pigmentation.
Let me guide you regarding your pigmentation problem. There are two important factors involved in the pigmentation of these areas:

1. Genetical Melanosis: The pigmentation at the facial, neck, underarm and groin areas is genetically determined. To tell you simply, the darkness is due to the activity of melanocytes in the skin. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. This is a tendency in us to get higher activity of these melanocytes at all these areas according to our genetic make up. It is seen on higher side in people of Asiatic origin than in white population. So accordingly in XXXXXXX skin it is seen on higher side as compared to white skin people.
So you do have the pigmentation tendency because of the above reason. The forehead pigmentation is specifically due to the same reason.

2. Secondly face area is further darkened by the process known as "Post inflammatory hyper-pigmentation" or PIH. The facial area is prone for sun damage and it causes over production of melanin in the skin. This pigmentation is known as "sun tanning". So by the production of melanin in excess, the area gets further darkened. This melanin is initially superficial in the epidermis (in upper skin) but later on becomes dermal (deep in the skin). Additionally on right side of your face when you use cell phones then the contact of phone itself causes more irritation and therefore there is further aggravation of pigmentation.

Though our superficial epidermal skin gets renewed every 28 days but because of the tendency of over secretion of melanin and the deep dermal pigmentation, it takes long period of time to get reduced. Therefore you should have enough of patience to see good results.

In my patients with your kind of problem I guide them for a holistic approach of :

"Diet + Sunprotection + Medications"

- In diet you should have best of vitamin C and vitamin A containing fruits along with lot of liquids everyday. Vitamin A in diet helps to give you sun-protection internally while vitamin C in diet helps in reducing the activity of melanocytes.

- For sun-protection you can use any good sunscreen regularly according to your skin type. Apply it every 3 hourly if you stay out side other wise two times is enough if you are staying in office. Use a hat or cover your face during outdoor visits.

- For medications If I were your treating dermatologist then would have prescribed combination approach with a cream (under dermatological supervision) containing Kojic acid with arbutin and mulberry extract in it for one night and Azelaic acid gel on the other night over the affected area of pigmentation. These are one of the best and safest creams to be applied. I suggest my patients to apply any of these creams in a very thin layer at night time only so that these should not be visible to naked eye. Apply at night time before sleeping.

One important thing is to reduce your weight. The mature look is not because of pigmentation alone young man, it is due to bit obesity also. You should reduce almost 10 kg from the present weight. Also I suggest you to do facial exercises to reduce facial fat. You can take help of internet with the key words:

"exercises to reduce facial fat"

and you will find so many of good maneuvers to reduce facial fat. This single feature alone will give you young look. Do some workouts and especially yoga to have fit and healthy life style.

I suggest you to meet a proper dermatologist near you to get best of guidance. Have good follow up for the same and specifically have patience to see the results.

I have seen that sun protection with good diet not only helps in renewing the skin better as well as works best to protect our skin.

I hope these informations will help you. I will be glad to reply any further queries. "Wish you good glowing skin"

Regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology

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Brief Answer:
Gel based sunscreen and kojic+ azelaic creams

Detailed Answer:
Hello young fellow,

Welcome again to the forum and thanks for asking further queries.

Regarding the Melalong cream- As you know it contains hydroquinone and tretinoin. Both of these contents are quite good and give proper results but considering the hot weather condition in northern and central XXXXXXX I do not prefer it in summer time. Especially tretinoin gives slight irritation and there is more redness leading to rebound hyper-pigmentation.

Therefore I prefer to use bit safer creams. As I already enumerated Kojic acid and azelaic acid alternatively produces good results. I guide my patients to apply these creams at night time in thinnest possible amount. A rule of thumb is that a pea size amount is sufficient for palm size area. So you can apply accordingly. Initially it may give you bit dry and flaky skin but later on as the cream gets adjusted (in 6 weeks) provides good results.

Regarding sunscreen – you can use any good sunscreen and there is no preference to anything specific. The additional part of information is that because of summer season I prefer to use gel based sunscreens( such as photoban gel or ultraguard 40+ gel).

Rest of all the suggestions are as previously.

I wish best and early resolution of the problem.

I will be glad to answer any further queries or if not then can close the discussion and rate the answer.

For any future clarifications and guidance you can ask me directly at:

bit.ly/drsanjaykanodia

“with glowing skin wishes”

Regards,

Dr Sanjay Kumar Kanodia
MD (Dermatology)

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Brief Answer:
Combination of kojic+ azelaic creams

Detailed Answer:
Hello young fellow,

The creams I have enumerated should be sued under dermatological supervision so that you should get best results. In my patients I use kojic acid (Clearz Ultra) and azelaic acid ( Aziderm 10% for few weeks then Aziderm 20% after 4 weeks).

The sunscreen can be used as told before and other suggestions are also to be followed promptly.

I will be glad to answer any further queries or if not then can close the discussion and rate the answer.

For any future clarifications and guidance you can ask me directly at:

bit.ly/drsanjaykanodia

“with glowing skin wishes”

Regards,

Dr Sanjay Kumar Kanodia
MD (Dermatology)

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