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Pigmentation on face, skin keeps deteriorating. Tried many medication and pixel laser. What to do now?

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Practicing since : 2005
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Hello Doc, I have been fighting pigmentation on my face for more than 3 years. Initially, I consulted a skin doc in 2009, he suggested me to apply depiwhite every night and used sunscreen (15+spf). I used it for almost a year, but I didn't see any changes. Later, I met a dermatologist from fortis hospital. He advised to to use kojivit gel every night, cap Antoxid every alternate day and suncrose, a sunscreen lotion whenever i go out, atleast before 15 mins. I continued for about a month, it lightens a bit but not to the extent that i was looking for; then he started glycolic peel every 15 days. I did 5 sessions, but still it didn't work; then later we went for TCA peels - 4 sessions every month. Last TCA peel was on 20th Oct 2011. Well after TCA peel it gets worsen, I got post hyperpigmentation scars. It was very visible now as If I met with any accident.Later doctor gave me to try Tretin Cream 4 times per week at night and as usual continuing Sunscreen thrice a day.
Then on 20/11/2011.. I had gone pixel laser, Feudin H (5 times), Neutrogena SPF 50 thrice a day, adv to wash face with Cetaphil cleanser twice a day.
It lasted for couple of months and my skin kept deteriorating. This year, doc advised to apply melacare forte every night and sebamed sunscreen (50), derantox antioxidant every month which I'm still taking. To my surprise, after a month, I can see the dark pigment faded away and I can see some kind of pinkish color on my face which was very good, but it didn't last long. The dark melasma came back again. Then doc feels that I got allergy to hydroguinone based cream. Then he gave me depiklen to apply every day twice a day. Plus mesoglow - some kind of injection of highly concentrated antioxidant and other lightning natural ingredients to my skin. But I didn't see any result. Then later a skinlite cream 0.2% hudroquinone based cream was advised to apply every worked for some days but again it came back. Now, he has given me melaglow to apply every night, eat derantox every day, sebamed 3 times a day. I'm using meladerm twice a day for a month now, but still the hyperpigmenatation is very visible. Is there a way out where I can get my natural skin. I felt that I shouldn't have met the doctors at all, I felt I have exploited my skin and left with no choice; I hardly go out to sun. Please help me.
Posted Mon, 25 Jun 2012 in Pigmentation Problems
Answered by Dr. Sudarshan 3 hours later

Thanks for writing in.

I understand your problem and will give you best possible advise.

I can see that you have undergone many procedures and applied many skin lightening creams also.

The exact causes of melasma are unknown, but it is generally believed that a combination of over-exposure to the sun mixed with external and XXXXXXX hormone changes lead to melasma.

It is common in females ,when present in males it is resistant to treatment.

My advise to you would be
-Maintain sunprotection with sunscreens and physical sun protection (umbrella/caps/hats/scarfs).You can any sunscreen with SPF 50 either neutrogena or sebamed. Apply it 2-3 times per day .Ideally after every 3 hours starting 8 AM morning.

-Take one fruit every day.Take lemon juice and other citrous foods as they are XXXXXXX in vitamin C and anti oxidants.Vitamin C is a XXXXXXX skin lightening agent.
You can continue with antioxidant like derantox or oxidon plus 1 capsule per day.

- You can use modified kliggmans formula skin lightening agent. Triglow cream is one such cream of which I have good personal experience in practice.Use it after consulting your dermatologist.

-Avoid laser treatments as it has high rate of recurrence.

-Another good option in your case is glycolic acid peeling. It has wonderful results in facial pigmentation.It can be combined with microdermabrasion.Combination treatment is more effective.

-Please understand that no treatment is 100% effective and there is NO permanent cure for melasma.Melasma is treatable but cannot be cured.With treatment pigmentation will get light but it can reoccur.

- Do not change skin lightening creams frequently as they take time to show effect from 1 -3 months.Do not change doctors frequently and stick to one qualified dermatologist.Discuss above mentioned treatment options with your doctor.

Hope this helps you .
If you have any further queries feel free to ask them.

Dr Sudarshan.
Above answer was peer-reviewed by
Follow-up: Pigmentation on face, skin keeps deteriorating. Tried many medication and pixel laser. What to do now? 3 hours later
Where can i get this modified kliggmans formula skin lightening agent & Triglow cream?
Answered by Dr. Sudarshan 19 hours later
Hi again ,

The creams are available in market better use them after consulting a doctor.

Hope this helps.
Dr Sudarshan
Above answer was peer-reviewed by
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