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I have read your query and have seen your photographs (attachment removed to protect patient identity). What I have seen is a blackish pigmentation over your forehead and around your eye along with ice pick, rolling and pock-like scars over your cheeks. The blackish pigmentation is termed periorbital hypermelanosis. The main culprits are stress factors including lack of sleep, overt sun exposure, etc.
The Probable causes:
Stress in any form.Differential diagnosis:
1. Pigmentary demarcation lines.Probable diagnosis:
2. Lichen planus pigmentosus.
Periorbital hypermelanosis.Treatment plan:
1. Start with depigmenting creams like Kojic acid (Kojivit) or Hydroquinone (HHlite) over the black areas in the night-time for two weeks along with sunscreen (Suncross UVA or Suncross Aquagel or Photostable cream).Regarding follow up:
2. Sunscreen should be applied compulsorily in the morning time within a span of 2-3 hours like 8:00 AM, 11:00 AM, and 2:00 PM all over the face.
3. For the scars a procedure called derma roller or microdermabrasion can be done by any skin doctor in your area because those scars will not come down with oral or topical medications.
Revert back after two weeks for review to a dermatologist online.---> https://www.icliniq.com/ask-a-doctor-online/dermatologist