Hi XXXXXXX

Thank you for the query,

Betnovate-n is a combination of steroid cream plus antibiotic cream.It is usually not used alone for pigmentation or should I say that it is not a first line treatment for pigmentation alone( esp for face) .
Firstly, for pigmentation it should be combined with a tretinoin cream or a hydroquionone base. Secondly it should not be used for long.If at all it is used in combination with the above creams then it should be used only for few weeks and then replaced with tretinoin or hydroquinone .
Creams containing steroids if used for long on face can lead to various side effects.The most common side effect seen in females would be growth of facial hair over the area. If used in cheeks it may lead to pimples , rosacea ,fine lines (wrinkles),telengectesia(fine capillaries),skin atrophy etc. It also leads to dependency and the moment one wants to stop it ,it may lead to stinging sensation or itching and even redness .The only cream which can help to withdraw steroid cream is topical tacrolimus. And it takes a long time to take over it.

My advise would be stop it immediately and consult a dermatologist who can help you withdraw it effectively if you are getting the above symptoms.

The best cream to use in your case depends upon the cause for pigmentation.So if you can briefly tell the the reason for pigmentation,then possibly I can suggest you a remedy and to prevent a relapse.

Anticipating your reply.

regards,
Dr.Bharat Chawda

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Hi XXXXXXX

Thank you for the reply.

Since you are not very sure as to how you developed the pigmentation and now that it has gone,I can only suggest you how to prevent the relapse.
Use a good spf sunscreen (esp medicated one) daily three times a day.
You can also use a combination cream containing kojic acid and vitamin c .This can be used twice a day.
This would even help you to get a even tone on face,but this may take a longer time.
You can even go for chemical peels from a dermatologist .Its a procedure where in a specific peeling chemical is used on face for few minutes.This would help to take away the XXXXXXX too.

But if you get a relapse of pigmentation then you can start with a triple combination cream(tretinoin + hydroquinone + steroid) for few days and then switch over to tretinoin or hydroquinone cream.

As far as becloderm-n is concerned I am not very sure but it does have a steroid and neomycin (same as betnovate-n).So kindly avoid this too.

I would suggest you to consult a good dermatologist who can prescribe you the above creams and combination .Kindly avoid any self medication .

I hope this answers your query,if you have any further questions ,kindly write back to us.I would be happy to answer them.

regards,
Dr.Bharat chawda

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Hi!,
Thank you for the follow up,

I appreciate your search for the treatment.

As I had earlier mentioned the triple combination cream(steroid + tretinoin + hydroquionone ) gives the best result .Following this you can use hydroquinone or tretinoin cream .Glycolic acid and azelic acid cream do not give good results ,but can be used in certain cases.

Again as I had discussed earlier about chemical peels ,which can be used in for pigmentation .There are various types of peels used like -glycolic acid ,salisylic acid,trichloracetic acid(TCA) ,retinol peel etc. Of all these, glycolic acid peels are best.TCA peels are very strong peels and not many doctors do this .

As far as electrical stimulation is concerned ,I would not recommend you this.

Iontophoresis is again not used routinely and not carried out at most of the places . And even not regarded as best of the therapy.It just helps in deeper penetration of the creams used.

Intense pulse light (IPL) is a machine (not a laser as lot of people think) which is meant to reduce pigmentation ,but ironically has no good result ,and can cause side effects as burn marks esp in Indian patients.Instead of IPL you can go in for Laser (Q-switched Nd:yag laser ) which is specific for pigmentation and safe too.
You can plan for this if you get a recurrence.

Recurrence of pigmentation has nothing to do with use of steroid ,and as i mentioned topical steroid alone is not recommended for the same either.

What you should do is stop betnovate for time being and continue using a good medicated sunscreen daily.If there is a recurrence then consult a dermatologist with laser expertise and discuss with him the above options.

I hope this would help you decide the best treatment option available at your place.

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