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Dr. Andrew Rynne

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Dark melasma like patches appeared on face. Not cured by hydroquionone. Alternate medicine?

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Dr. Sudarshan

Dermatologist

Practicing since :2005

Answered : 1391 Questions

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Posted on Wed, 9 Jan 2013 in Pigmentation Problems
Question: Dear Doctor,

Hoping to get a solution to my problem.
I am a 29 year old fair complexioned woman. Over the last 4 years, my face has become 3 shades darker than the rest of my body and also developed symmetrical dark melasma like patches near the cheekbone area. I have used various medications starting with hydroquionone, retinoids, glycolic acids and high end cosmetic brands. During the usage of hydroquionone, there was a great improvement but later had bad reaction and my face started becoming darker again. All high end cosmetics seem to superficially improve my condition but after a few days of usage, the problem returns. I avoid sun exposure to the maximum and also use sun block when I step out. I am desparate to find a solution.
Thank you!!
doctor
Answered by Dr. Sudarshan 4 hours later
Hi XXXXXXX
Thanks for writing in.
Melasma is a common condition occuring due to hormonal changes and sun exposure.As you are using sunblock continue the usage.
You can try Kligmans modified formula cream like Triglow cream only at night over the affected area.It will give faster results.Use it for 3- 4 weeks.
Then after 1 month you can shift to Depiwhite cream which is steroid and hydroquinone free alternative.You can use it safely for months together to maintain the good results obtained.
Use good quality moisturizer all the time while using these creams.
Maintain Sun protection with good sunscreen like Melagaurd sun screen with SPF 50.
You can use Venusia soap or dove soap for face.
Take a lot of vitamin C in diet and drink lot of water to maintain hydration of face.
Vitamin C inhibits melanin synthesis in screen and also it helps in lightening the skin.
Take one anti oxidant capsule like Cap.Derantox daily.This helps in skin lightening and prevents oxidative damage in skin.
Consider visiting a dermatologist for Chemical peeling and other procedures for maintaining good long term effect.

Hope this helps.
I will be available for follow up.

Regards.
DrSudarshan
MD
Dermatologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 6 hours later
Hello Doctor,

Thank you for the prompt response. Just to let you know that I was treated with hydroquinone 4% and also corticosteroid creams like diprovate. Now, I feel my skin reacts badly to hydroquinone and kojic acid as I don't see any improvement but witness rebound hyperpigmentation. I have undergone chemical peels too with no much help. I am looking for any alternative prescription besides vitamin c, kojic acid or hydroquinone. As suggested, I will incorporate Derantox cap in my regimen.

Thanks and Regards, XXXXXXX
doctor
Answered by Dr. Sudarshan 16 hours later
Hi again,
You can start with DEPIWHITE cream it is hydroquinone and steroid and vitamin c free.
Also maintain strict photoprotection while using the cream.Continue with Cap. derantox .
Diprovate cream contains betamethasone cream.It should not be used over face and may cause thining of skin as in your case.
Use good quality moisturizer cream with XXXXXXX butter .
Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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