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Diagonised with hyperpigmentation in cheeks. Using Nadicin cream. Now suggested to use Xtralite. Remedy?

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Practicing since : 2006
Answered : 2015 Questions
I am diagonised with hyperpigmentation in cheeks (melasma). I have tried Nadicin C(clobetasol propionate) cream. Though it has lightened other parts of the face not much of a result is seen in affected area. Now I am being suggested to use Xtralite (Hydroquionine) ointment. It has minor irritating feeling. Pls suggest a suitable remedy or if the same treatment can be continued.
Posted Sun, 29 Sep 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 40 minutes later
Brief Answer:
Please read a detailed answer below

Detailed Answer:
Thanks for writing to us.
So you have been diagnosed with melasma. Treatment of melasma mainly depends upon depth of pigmentation. If the lesions are brown in color, these are superficial and respond favourably. If lesions are darker or slate gray response is usually suboptimal.
Clobetasol cream is a potent steroid cream not at all indicated over face for prolonged use. So please do not use it over face. Xtralite is a combination cream containing milder steroid, hydroquinone and tretinoin. Redness, irritation burning sensation usually occurs when used in larger quantities. As you are having slight irritation , I would advise that you discontinue its use for few days. If still redness or irritation persists use a mild steroid like hydrocortisone over face for two to three days to settle irritation.
The treatment plan for melasma could be
1) take oral antioxidant and vitamin c supplement like antioxid HC/ exerge HC/ sodox etc and limcee/ celin daily
2) use a good sunscreen with SPF atleast 30. Apply it atleast 30 minutes prior to leaving home and reapply after three to four hour. Sun exposure can worsen melasma and hence adequate protection is required
3) reintroduce Xtralite cream again but apply it in very small quantities. It should be applied in night only and atleast half an hour prior to bedtime.

Follow these suggestions for three weeks to see how much response you get.
If response achieved is desirable shift to milder depigmenting creams with Kojic acid, arbutin, vitamin c etc like kojivit once daily. If response is suboptimal use hydroquinone 4 percent cream in night along with Kojic acid based or Glycolic acid based cream in morning for another month.
Also please consult a dermatologist nearby for follow up and guidance.
Hope that helped
Take care
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