Q. What is the treatment for hyperpigmentation on cheeks and forehead that reoccur, once tablets are stopped?

Hello,

Welcome to icliniq.com.

Thanks for writing in, and I understand your concern.

This condition can be melasma. Melasma is a hyperpigmentation disorder characterized by dark patches over cheeks, nose, forehead, and rarely on hands. It usually happens due to some hormonal causes and can get worse with sun exposure. The treatment is based on reducing the pigmentation and preventing further pigmentation. Treatment is given for four weeks initially. So it is advisable to follow up after four weeks. Please do not continue treatment after four weeks without a doctor's consultation.

I suggest you take the following medication.

1. Melalite forte cream (Hydroquinone) for local application on spots at night.

2. Aziderm 20 % cream (Azelaic acid) for local application on spots in the morning.

3. Photostable gold gel apply all over the face before going out in the sun once in the morning. Apply it 30 minutes after the Aziderm 20 % cream application without washing Aziderm.

4. Tablet Limcee (Vitamin C) once a day after breakfast.

I suggest reviewing after four weeks. If you have any doubt, kindly revert.

Thanks and regards.

Hi,

Welcome back to icliniq.com.

The oral medicine I suggested above is Tablet Limcee (Vitamin C). It does not have many side effects, if taken once a day. There is no need to avoid any food while taking these medicines. I suggest you consult after four weeks. Change of medication can be suggested accordingly. Stopping abruptly might lead to recurrence. If irritation or itching due to cream is too much, I suggest you withhold it for two to three days and apply only sunscreen and any moisturizer. I suggest you use Epilyno lotion as an anti-aging cream and moisturizer with this treatment.

Regards.

Hello,

Welcome back to icliniq.com.

I understand your concern.

As you have not noticed any burning or erythema, and there is a mild improvement too, better to continue the treatment for the next six weeks. A change of medicines might be required after 6 to 8 weeks unless you have any burning or redness.

So the next step is to continue for at least six weeks and use your sunscreen regularly. I also suggest using:

1. Cream Aziderm 20% (anti-acne cream).

2. Cream Melalite forte (Hydroquinone 4%) (total duration of this cream should not be more than three months).

3. Photostable gold sunscreen.

4. Tablet Limcee 500 mg (vitamin C supplement) once daily.

Review after six weeks.

Take care.

Hi,

Welcome back to icliniq.com.

It depends. If using the prescribed medications and anti-aging cream together does not cause burning or redness, you can apply at a gap of 10 minutes.

I suggest using Rejuglow face wash (Glycolic acid and Salicylic acid). It will be suitable for pigmentation as well. But it can cause a bit of dryness. Use any moisturizer if that happens.

Take care.

Hello,

Welcome back to icliniq.com.

I understand the concern.

Thanks for sharing the pictures (attachments are removed to protect the patient's identity).

It looks better than before. It has been two months since the start. You can continue using melilite forte cream for two more weeks.

Also, I suggest using the following medications:

1. Cream Melalite forte (Hydroquinone 4 %) as before for two more weeks.

2. Glyco 6 Cream (Glycolic acid 6 %)( replace Melilite forte with this cream after two weeks).

3. Aziderm 20% cream (anti-acne cream).

4. Photostable gold sunscreen

3. Tablet Limcee 500 mg (vitamin C supplement) once daily.

Review after one month.

Take care.

Hi,

Welcome back to icliniq.com.

Thanks for sharing the picture (attachment removed to protect the patient's identity).

If Melalite forte is causing burning, please stop using it now. You can use Glyco 6 cream at night, along with sunscreen.

Melasma can not be completely cured, and mild recurrences are common. That is why one needs to use regular sunscreens and creams for maintenance, like Glyco 6 cream. Stop using all creams for a couple of days, and only use moisturizer and sunscreen for now. Then start Glyco 6.

Take care.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Dilip Kumar Meena

Experience: 17 + Yrs

Dermatology

---

Related Questions:
Is there any way to get rid of post acne hyperpigmentation?

.. acne hyperpigmentation lasting for so long is not very common. 2. There are two kinds of options for post inflammatory hyperpigmentation. Either using creams at home which I will prescribe you below or going for cosmetic procedures like microderm...   Read full

What should I do to reduce the hyperpigmentation and dark circles under my eyes?

I am using Bepanthen and sunscreen ... Use a broad-spectrum sunscreen throughout the day ...   Read full

I have melasma on my face for the last 16 years. Why does not any cream help?

If melasma remains resistant even after taking treatment, then it is good to do chemical peels ...   Read full