Brief Answer:
Dark elblows and knees

Detailed Answer:
Hello,
Welcome to healthcare magic.

I understand from your query that you are concerned about dark elbows, knees and lips.

I have seen your clinical pictures.

It seems to me that the darkening of your knees and elbows is constitutional and may be made worse by friction and dryness. By constitutional, I mean that it is a normal part of your skin tone. From your surrounding skin colour, I see that you have a darker skin tone, called as XXXXXXX XXXXXXX Type 4/5. This is the skin tone in many Indians. People with such skin tone tend to have darker skin (darker than the rest of their body) on the friction prone areas like elbows and knees. Even the lips tend to be darker even without any cause.

I would suggest you the following-

1. Avoid friction of any sort. If you are resting your elbows on the desk constantly while at work, consciously make an effort to keep them away. Without our knowledge, we tend to rest our elbows on the desk/ table.
Also avoid activities which could cause friction on your knees. ( kneeling, etc)

2. Use a good moisturizer containing urea and lactic acid ( e.g- Moisturex cream) twice a day morning and evening on your elbows and knees. This will moisturize the thick and rough skin and also cause some desquamation effect. This will help to make it smoother and thus it will appear lighter.

3. Use a cream containing 12 % glycolic acid ( e.g- Glyco -12 cream) at bedtime on the elbows and knees. This will help to lighten it further.

4. Do not scrub the area.

As far as your lips are concerned, darkening could be familial or constitutional.

1. You could use a cream containing aloe vera ( e.g- Elovera cream ) twice a day.

2. Q-switched Nd- Yag laser is showing good results to lighten the pigmentation in these cases. You could consult a cosmetic dermatologist for the same.

Hope this helps you.

Take care,
Dr. Johny Chacko

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