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Suggest Treatment For Facial Skin Pigmentation
Question: Hello Doctor
My wife is suffering from facial skin pigmentation problem. We are married for around 3 years. Currently she is 7 months pregnant. It was started some 2 years back (around 1 year after marriage). First it was started slowly from her under eye and then near the chin area and then to the forehead and now it is spreading towards her neck. Before 6 month her face was like black and white patches all over the face. But now the skin color becomes full black, though she was fair originally. Now her face skin is dry and sometime it peels out also. When it was started, we consulted some doctors, even some skin clinic like XXXXXXX they said it is a sign of pigmentation, due to direct contact with sun light. May be her skin is not able to bear the sun light. We stay in XXXXXXX XXXXXXX And here the atmosphere is not so hot also. But the fact is, she is a home maker & does not exposed to sunlight throughout the day. Maximum in a day she goes out for a walk for 30 minutes and that to in the afternoon. We have tried all those medicine from the doctors but no result, even it went worst. After some days we started planning for a baby, so we stopped all the medicine & meeting with doctors. Please suggest us to prevent her from spreading this more and recover from this. Please let me know if this is not the right time for treatment. We can get in touch after the baby’s delivery. I am attaching her earlier & current photos for your reference. Please check and guide us.
Thanx and regards
XXXX
0000
My wife is suffering from facial skin pigmentation problem. We are married for around 3 years. Currently she is 7 months pregnant. It was started some 2 years back (around 1 year after marriage). First it was started slowly from her under eye and then near the chin area and then to the forehead and now it is spreading towards her neck. Before 6 month her face was like black and white patches all over the face. But now the skin color becomes full black, though she was fair originally. Now her face skin is dry and sometime it peels out also. When it was started, we consulted some doctors, even some skin clinic like XXXXXXX they said it is a sign of pigmentation, due to direct contact with sun light. May be her skin is not able to bear the sun light. We stay in XXXXXXX XXXXXXX And here the atmosphere is not so hot also. But the fact is, she is a home maker & does not exposed to sunlight throughout the day. Maximum in a day she goes out for a walk for 30 minutes and that to in the afternoon. We have tried all those medicine from the doctors but no result, even it went worst. After some days we started planning for a baby, so we stopped all the medicine & meeting with doctors. Please suggest us to prevent her from spreading this more and recover from this. Please let me know if this is not the right time for treatment. We can get in touch after the baby’s delivery. I am attaching her earlier & current photos for your reference. Please check and guide us.
Thanx and regards
XXXX
0000
Brief Answer:
Lichen Planus pigmentosus; sun protection &pigment reducing agents
Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic
I have taken note of your query and I have understood it. I have also reviewed the Images.
Her skin condition is known as Melanosis and the likely possibility is Lichen planus pigmentosus/ LPP.
Lichen planus pigmentosus usually presents as brown to dark brown/ bluish patches on face, neck, arms.
Other body areas like abdomen, legs etc may also be involved.
Lichen planus pigmentosus is idiopathic in most of those who have it i.e there is no known cause.
Sun exposure definitely plays a part in LPP but why does sun induces pigmentation in some individuals and not in others is not known.
Therefore, Sun protection is an essential part of treatment of LPP.
I suggest a broad spectrum sunscreen for her, to be applied, throughout the day, even when indoors.
Neutrogena dry touch ultrasheer sunscreen is an OTC brand which is broad spectrum (spf 50+). She may use it every 2-3 hours, throughout the day.
At night she may use a cream containing a mid potent topical steroid e.g mometasone furoate 0.1% in a cream base for 4-6 weeks, over these dark areas.
However, since topical steroids cannot be used on her face for ever, therefore once the initial response is achieved with topical steroids she can be switched to a cream containing one or more of the pigment reducing agents like azaleic acid, kojic acid, glycolic acid, arbutin, hydroquinone etc to be used over dark areas at night.
She may also opt for a few sessions of chemical peeling from a dermatologist, once the baby is delivered.
Having said that LPP is slow responding and pigmentation is sometimes stubborn Or very slow to respond.
Treatment has to be regular and may extend to months or even years for good results.
She should avoid all other cosmetics and face creams other than the medications i.e sunscreens and pigment reducing agents, as mentioned.
Regards
Lichen Planus pigmentosus; sun protection &pigment reducing agents
Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic
I have taken note of your query and I have understood it. I have also reviewed the Images.
Her skin condition is known as Melanosis and the likely possibility is Lichen planus pigmentosus/ LPP.
Lichen planus pigmentosus usually presents as brown to dark brown/ bluish patches on face, neck, arms.
Other body areas like abdomen, legs etc may also be involved.
Lichen planus pigmentosus is idiopathic in most of those who have it i.e there is no known cause.
Sun exposure definitely plays a part in LPP but why does sun induces pigmentation in some individuals and not in others is not known.
Therefore, Sun protection is an essential part of treatment of LPP.
I suggest a broad spectrum sunscreen for her, to be applied, throughout the day, even when indoors.
Neutrogena dry touch ultrasheer sunscreen is an OTC brand which is broad spectrum (spf 50+). She may use it every 2-3 hours, throughout the day.
At night she may use a cream containing a mid potent topical steroid e.g mometasone furoate 0.1% in a cream base for 4-6 weeks, over these dark areas.
However, since topical steroids cannot be used on her face for ever, therefore once the initial response is achieved with topical steroids she can be switched to a cream containing one or more of the pigment reducing agents like azaleic acid, kojic acid, glycolic acid, arbutin, hydroquinone etc to be used over dark areas at night.
She may also opt for a few sessions of chemical peeling from a dermatologist, once the baby is delivered.
Having said that LPP is slow responding and pigmentation is sometimes stubborn Or very slow to respond.
Treatment has to be regular and may extend to months or even years for good results.
She should avoid all other cosmetics and face creams other than the medications i.e sunscreens and pigment reducing agents, as mentioned.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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