Brief Answer:
Firstly the cause needs to be ruled out.

Detailed Answer:
Hi XXXXX,
Thanks for writing to us.
There could be many causes for facial pigmentation like melasma, post inflammatory hyperpigmentation, photo damage, dermatitis,lichen planus pigmentosus, ashy dermatosis, use of cosmetics, fragrant creams, hair dyes.
Treatment may vary depending upon the cause.
I would like to know
the areas involved over face and if other body areas are involved with similar pigmentation.
since how long are you having it
color of pigmentation- brownish or slate grey
amount of sun exposure per day
if on any medication or taking oral contraceptives
any preceding skin lesions over face
treatment or medicines taken so far

I would also appreciate if you could attach an image depicting your facial pigmentation clearly as it would help me most in diagnosing the condition and suggesting treatment.
Hoping to hear from you soon.
Take care

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Brief Answer:
It is melasma

Detailed Answer:
Hi XXXXX
Thanks for providing me with all the valuable details. I have also gone through the images attached.
You seem to be having melasma. Melasma could be related to sun exposure, intake of medicines esp oral contraceptives and may also occur during pregnancy.

Response to treatment in melasma depends upon the depth of pigmentation. As the color of lesions in your case is brownish, so mst probably you will have good clearance of these lesions. One concern with melasma is its recurrence but that can be taken care of by using a pigmentation reducing cream and sunscreen.

Now the treatment protocol should be
1) take an oral antioxidant daily
2) Use a sunscreen with good UVB and UVA protection. For the same check its SPF( atleast 30) and PA rating. Sunscreen should be used half an hour prior to stepping out in morning and should be repeated every three hours between 10 am to 4 pm irrespective of weather conditions.Even if indoors apply it in morning
3) in night use a hydroquinone , tretinoin and steroid based cream. Also once in a day whenever possible use Glycolic acid 12 percent or Azelaic acid 20 percent cream. All these creams have an irritant potential, so please use in small amount just enough to cover the face. Also do not rub the cream.

Also if possible please take few sessions of TCA peels.
Follow these suggestions for a month and see the response.
Usually with these steps your melasma should almost clear. Once desirable results are achieved, USDA sunscreen in morning and continue with mild Kojic acid or Glycolic acid cream to prevent further recurrence. Also chemical peeling sessions can be taken once in a while to keep pigmentation at bay.
Hope that helped.
Take care

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Brief Answer:
Please read detailed answer below

Detailed Answer:
Hi,
I mentioned the salt names as it would be easier for you to look for it in your city / country of residence.

Here in India these are available as
antioxidant- antioxid HC, exerge HC, derantox etc
Sunscreen- shades, photoban, photobloc, suncross, ansolar
HQ tretinoin steroid cream- skinlite, cosmelite, Eveglow, lomela, clearz XXXXXXX
Glycolic acid cream- glyco A
Azelaic acid cream- Azac, aziderm
Kojic acid cream- kojivit, carofit ultra etc.


Hope this helped.
Take care

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Brief Answer:
Please see the answer below

Detailed Answer:
Hi,
thanks for writing back.
take tablet antioxid HC daily
apply shadowz sunscreen in morning
Use glyco A 12 percent cream once in a day
Apply clearz XXXXXXX cream in night

follow the same for a month and then you may get back for follow up.
Hope that helped.
Take care

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