How to manage my hypothyroidism and perioral pigmentation?

Question

Hello doctor,

I am a 19-year-old girl and would like to get it treated. I have perioral pigmentation. The pigmentation started one year ago. It may have developed due to threading done without using cream, and I also have hypothyroidism.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand that perioral hyperpigmentation, or facial pigmentation in general, can affect the overall appearance of the face. Perioral pigmentation is quite common, especially at this age. Based on the description and the attached photograph (attachment removed to protect the patient’s identity), there appears to be significant hyperpigmentation around the mouth area.

This pigmentation may have been triggered by repeated threading without adequate skin protection, which can cause irritation followed by post-inflammatory hyperpigmentation. Hypothyroidism can also contribute to this condition by slowing skin repair and making pigmentation more persistent. Therefore, maintaining well-controlled thyroid hormone levels is important for visible improvement. There is no need to worry, as a step-by-step routine can help manage this condition effectively.

For daily skin care, begin with a gentle facial cleanser used in the morning and at night to remove excess oil, dirt, and sweat without irritating the skin.
After cleansing, apply a non-comedogenic, barrier-repair moisturizer, preferably one containing ceramides, to help strengthen and repair the skin barrier, which is essential during pigmentation treatment.
In the evening, apply a pea-sized amount of a cream containing Kojic acid and Glycolic acid to the pigmented perioral area.
These ingredients help reduce pigmentation, improve dark marks, and smooth skin texture.
A moisturizer should always be applied afterward to minimize dryness or irritation.
This routine should be followed consistently for six to eight weeks, as pigmentation takes time to fade.
Threading, waxing, or other harsh hair-removal methods should be avoided in the affected area during this period.
Rubbing or scrubbing the skin should also be avoided.
Daily use of a broad-spectrum sunscreen is essential, as sun exposure can worsen perioral pigmentation even with minimal outdoor exposure.

With patience, consistent skin care, and proper management of hypothyroidism, gradual and visible improvement can be expected.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.