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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Facial Darkening Spots Which Are Persistent Be Treated?

Sir, I had some darkspots on my face. I got suggests from a doctor that to use melabest but when I stooped using this cream my skin turned more darker than before. what should I do to get cure.now I' am using lomela with out sunban cream.will it be cure?
Mon, 9 Feb 2015
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Dermatologist 's  Response
Hello. Thank you for writing to us

You seem to have a condition known as Melasma.
Melasma is characterized by dark patches on face, specially malar prominences and dorsum of nose.
Sun protection/ sunscreen use is an essential part of management of melasma, therefore, I suggest you to use a broad spectrum sunscreen, throughout the day i.e it should have both UV A as well as UV B coverage.
It should be reapplied every 2-3 hours, specially outdoors.
Apart from sunscreens, pigment reducing agents like hydroquinone, glycolic acid, kojic acid, azaleic acid, tretinoin etc are essential part of overall treatment of melasma. These ingredients can be used either alone or in combination.
The mode of action of these pigment reducing agents is either by exfoliating existing pigment Or inhibiting synthesis of new pigment Or both.
The creams that you have been using are essentially the same i.e they are a combination of tretinoin, hydroquinone and a topical steroid.
This is a gold standard combination for treatment of melasma however this combination is advisable only for the initial 6-8 weeks and is not for regular use because it can cause side effects like acne, sun sensitivity and hirsutism in females.
After the initial 6-8 weeks treatment must be switched to other pigment reducing agents like kojic acid, azaleic acid, glycolic acid etc which are safer for long term use/ maintenance.
Melasma may recur, therefore, maintenance of improvement is important with one of the pigment reducing creams along with strict sun protection with a sunscreen.
I suggest you to consult a dermatologist more more details and the needful.

Regards
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How Can Facial Darkening Spots Which Are Persistent Be Treated?

Hello. Thank you for writing to us You seem to have a condition known as Melasma. Melasma is characterized by dark patches on face, specially malar prominences and dorsum of nose. Sun protection/ sunscreen use is an essential part of management of melasma, therefore, I suggest you to use a broad spectrum sunscreen, throughout the day i.e it should have both UV A as well as UV B coverage. It should be reapplied every 2-3 hours, specially outdoors. Apart from sunscreens, pigment reducing agents like hydroquinone, glycolic acid, kojic acid, azaleic acid, tretinoin etc are essential part of overall treatment of melasma. These ingredients can be used either alone or in combination. The mode of action of these pigment reducing agents is either by exfoliating existing pigment Or inhibiting synthesis of new pigment Or both. The creams that you have been using are essentially the same i.e they are a combination of tretinoin, hydroquinone and a topical steroid. This is a gold standard combination for treatment of melasma however this combination is advisable only for the initial 6-8 weeks and is not for regular use because it can cause side effects like acne, sun sensitivity and hirsutism in females. After the initial 6-8 weeks treatment must be switched to other pigment reducing agents like kojic acid, azaleic acid, glycolic acid etc which are safer for long term use/ maintenance. Melasma may recur, therefore, maintenance of improvement is important with one of the pigment reducing creams along with strict sun protection with a sunscreen. I suggest you to consult a dermatologist more more details and the needful. Regards