Brief Answer:
Kinldy elaborate query and send pictures.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for hyperpigmentation on the upper portion of the face with tanning of skin.

In view to help you best I humbly request you to kindly elaborate your concern in terms of certain important things:

- Since how long you have the hyperpigmentation.

- Did the marks appeared gradually or suddenly.

- Do you feel any burning or itching over same. If yes then grade -mild/moderate/severe.

- Any other symptom felt by you on the marks.

- any medications used as cream and to eat for the treatment of pigmentation.

- Tell me about occupation with your daily routine including your diet, exposure to sunlight or computers.

- Any history of smoking or alcohol.

I also request you to upload good resolution pictures of the affected ares. It is utmost important to diagnose the exact entity. You can upload the report by utilizing our service. For that you have a feature to upload images of the reports by yourself at the right side of the query page. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia.

"Wish you good health"

Regards,

Dr Sanjay Kumar Kanodia
MD (Dermatology)

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Brief Answer:
"Sunprotection + Medications"

Detailed Answer:
Hello young fellow,

Welcome again and thanks for posting further information as well as the good resolution pictures.

After getting the informations and analyzing the pictures I can make out that you have moderately dark pigmentation.

Let me guide you regarding your pigmentation problem. There are two important factors involved in the pigmentation:

1. Genetical Melanosis: The pigmentation on the skin is determined by genetical or hereditary features. To tell you simply, the darkness is due to the activity of melanocytes in the skin. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. This is a tendency in us to get higher activity of these melanocytes at exposed areas according to our genetic make up. It is seen on higher side in people of Asiatic origin than in white population. So accordingly in XXXXXXX skin it is seen on higher side as compared to white skin people.

2. Secondly face area is further darkened by the process known as "Post inflammatory hyper-pigmentation" or PIH. The facial area is prone for sun damage and it causes over production of melanin in the skin. This pigmentation is known as "sun tanning". So by the production of melanin in excess, the area gets further darkened. This melanin is initially superficial in the epidermis (in upper skin) but later on becomes dermal (deep in the skin). Additionally on right side of your face when you use cell phones then the contact of phone itself causes more irritation and therefore there is further aggravation of pigmentation.

Though our superficial epidermal skin gets renewed every 28 days but because of the tendency of over secretion of melanin and the deep dermal pigmentation, it takes long period of time to get reduced.

In my patients with your kind of problem I guide them for a holistic approach of :

"Diet + Sunprotection + Medications"

- In diet you should have best of vitamin C and vitamin A containing fruits along with lot of liquids everyday. Vitamin A in diet helps to give you sun-protection internally while vitamin C in diet helps in reducing the activity of melanocytes.

- For sun-protection you can use any good sunscreen regularly according to your skin type. Apply it every 3 hourly if you stay out side other wise two times is enough if you are staying in office. Use a hat or cover your face during outdoor visits.

- For medications If I were your treating dermatologist then would have prescribed combination approach with a cream (under dermatological supervision) containing Kojic acid with arbutin and mulberry extract in it for one night and Azelaic acid gel on the other night over the affected area of pigmentation. These are one of the best and safest creams to be applied. I suggest my patients to apply any of these creams in a very thin layer at night time only so that these should not be visible to naked eye. Apply at night time before sleeping.

I suggest you to meet a proper dermatologist near you to get best of guidance. Have good follow up for the same and specifically have patience to see the results.

I have seen that sun protection with good diet not only helps in renewing the skin better as well as works best to protect our skin.

I hope these informations will help you. I will be glad to reply any further queries. "Wish you good glowing skin"

Regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology

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