Kindly suggest a treatment for hyperpigmentation present around the mouth for three years.

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I understand your concern. There are no attached photographs in your message. Kindly send a picture of the affected area to assess the condition and to suggest appropriate diagnosis and treatment.

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Thanks for sharing the picture. I have gone through it (attachment removed to protect patient identity). You have facial melanosis and it is caused due to hormonal or cosmetic contact dermatitis. I suggest you stop using all the products used over the face whether it is a moisturizer, sunscreen, or oil, or any other cosmetic products and also hair dyes. Use the following medicines for three weeks and have a follow-up. You can use Metalite forte cream (Hydroquinone 4 %) and Momate cream (Mometasone). Mix them in a 1:1 ratio on your palm at the time of application and apply it once at night on the marks. Review back after three weeks. You can use a Cetaphil moisturizer (Cetyl alcohol with Benzyl alcohol) if the skin is dry and use Cetaphil cleanser (Sodium Lauroyl Sarcosinate) as a face wash. Please stop using other cosmetic products over the face. Please mention the medicines and cosmetics used over the face. Please mention whether you have pigmentation inside the mouth or tongue.

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Tongue pigmentation occurs physiologically and it is essentially normal or it can be a part of Addisonian pigmentation. Follow the suggested medications. You can do the following test such as ACTH (adrenocorticotrophic hormone) stimulation test and serum cortisol. Review back with the reports.