Suggest remedies for pigmentation marks, acne on face and hair loss

Posted on Sat, 30 Jul 2016 in Skin Hair and Nails
Question: Hi Doctor,

I need to know the following things.

1. Treatment for face whitening.
2. Treatment to remove deep scar in Glabellar region.
3. Treatment to remove facial acne.
4. Treatment to get lost scalpe hairs back.

It would be really appreciated if the responses are inline and categorized the way its asked.

Answered by Dr. Kakkar S. 52 minutes later
Brief Answer:
Advice regarding pigmentation, acne and hair loss

Detailed Answer:
Hello. Thank you for writing to us

I am Dr. Kakkar. I have read your question and I have noted your concerns

1. Pigmentation of skin type is genetically determined i.e the activity of melanocyte and genetic variations in melanocyte receptors (MC1R) determine the skin color. Certain genetic variations in MC1R gene responsible for light color are more prevalent in certain ethnic groups like scandinavians and europeans than in asians or orientals. This varoation being despite the samme number of melanocutes in white's as compared to blacks!! Therefore it is not entirely possible to whiten the skin due to genetic constraints. Nevertheless, darkening of complexion due to excess melanocyte overactivity can be improved to an extent if certain measure like sun avoidance (sun and UV R is the most common cause of melanocyte overactivity) in combination with demelanizing cream e.g Kojic acid, hydroquinone, glycolic acid is used. You may use a broad spectrum sunscreen throughout the day e.g Neutrogena dry touch sunscreen, every 2-3 hours on all exposed skin. At night you may use a glycolic acid based preparation e.g Glyco 6 % cream

2. I would request you to kindly upload an Image of the deep scar in glabellar region so that I am able to guide you better. You may upload Image in "Reports Section"

3. For acne, you may use topical benzoyl peroxide 4% gel (Brevoxyl cream), twice daily. You should not use Glyco-6 % cream while you are using Brevoxyl cream because together they can cause irritation. Start Glyco 6 once your facial acne is under control. In addition, oral treatment may be required if your acne in inflammatory i.e red, pustular. Oral treatments may be in the form of oral antibiotics like doxycycline Or isotretinoin.

4. Alopecia in males is commonly due to underlying genetic predisposition and is characterized by hair loss and thinning, mainly from the front, top and vertex of the scalp. This pattern of hair loss is classical of androgenetic alopecia. Treatment modalities that are approved for androgenetic alopecia are topical minoxidil 5% solution (Mintop forte), 1ml, twice daily and Oral finasteride tablet (Finax), once daily.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
Follow up: Dr. Kakkar S. 3 hours later
Thanks for the detailed response doctor.

1. For the whitening part, am currently using 4% Hydroquinone- Melalite cream since 2 weeks. with this i could see some improvement. Should i continue using this or you want me to switch to Glyco 6% or any of the kojic acid cream?

2.I uploaded my deep scar pics. Please refer and suggest some medications to completely remove it and level the forehead temple region.

3.I uploaded the pics of cheek acne as well. For this should i be using Brevoxyl cream ryt away? How much time will it take to completely get rid of acne.

4. For Hair loss, am using Hair4u 5% Lotion since last 1 year, earlier 2 3 years i tried different variations of minoxildil with Oral Finpecia tablet. But i still couldnt see hair regrowth with this treatment. Any suggestions for better result. My front portion and the edges of head is loosing its density day by day and scalpe is clearly visible coz of lesser density. Please suggest where am i going wrong. Herieditory my father still has good amount of hairs on his head.

5. I have black and red spots of pimples in front and back side of the body. Anything to be done to clear the skin(without black or red spots) in front and back side of the body. Please refer the images.

Answered by Dr. Kakkar S. 15 hours later
Brief Answer:
regarding acne pigmentation and hair loss

Detailed Answer:

You may continue with melalite cream. It is also a good option.

For scar on forehead i would suggest fractional CO 2 Laser. Medications wont work for depressed atrophic scar.

You may apply brevoxyl cream on chest and back as well as use brevoxyl creamy wash for bath. Dont use it on face since you are using melalite and together they can cause irritation. Use instead clindac A gel for facial acne.

Regarding hair loss you can continue with minoxidil and finasteride however since these seem insufficient you may simultaneously also opt for PRP sessions gor better results.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Kakkar S. 25 hours later
Thanks for the response doctor.

1. Which one would be effective(quick results with minimal/0 side effects) -> Melalite / Glyco 6% / Kojic Acid.

2. Can you give more details abour CO 2 Laser
a. how it works - process and its technicality.
b. cost of the treatment.
c. duration to see the results.

3. Can i use brevoxyl cream for both facial acne(stopping Melalite for a while until acne gets cleared. Whats the effective duration to clear off facial acne) and front and back spots?

4. I will continue using Hair4U lotion with Finpecia. Do we have any better option for this, as this seems to be less effecient.

5. Can you please review this product and suggest your opinion.

http://www XXXXXXX in/Bioma-Scars-Stretch-Uneven-Dehydrated/dp/B018ZDOUI6/ref=sr_1_2?ie=UTF8&qid=0000&sr=8-2&keywords=bioma+oil

6. For Hairs, am using the following supplement. Could you please provide your inputs on this product as well.

http://www XXXXXXX in/Morpheme-Hair-Vital-Glow-Caps/dp/B01CZGUA7Y?ie=UTF8&psc=1&redirect=true&ref_=oh_aui_detailpage_o00_s01

Please respond inline to the questions. It would have better readability and we can never miss on the queries.
Answered by Dr. Kakkar S. 20 hours later
Brief Answer:
Answers to specific queries

Detailed Answer:

1. All are effective. They have different mechanisms of action. You can either continue only with melalite, 2x daily Or you can use kojic during the day and melalite at night. Avoid glyco- 6% with melalite as together they can cause irritation.

2. CO 2 laser works by stimulating synthesis of new collagen in dermis which would fill up/ lift the scar. You may notice 30-70% overall improvement with 4 sessions. Cost of treatment for a small area on forehead would not be much. It would take 3-4 sessions at a gap of 1-2 months for a cost of around 8-10k, depending on the setting.

3. Brevoxyl cream can be used for both face (provided you stop melalite) and back. You would notice improvement in around 2 weeks and significant improvement in 2-4 weeks. Further treatment would depend on the response.

4. You can switch to 10% minoxidil (Mintop 10) rather than 5% minoxidil (hair 4u)

5. I am against using these otc products for scars and hair. These are not proven therapies and can cause side effects. Doctors never prescribe these.
Bio oil can aggravate your acne. Though you may take Hair vital glow capsules along with specific treatment (i.e minoxidil and finasteride) for hair fall and not as a sole therapy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Kakkar S.


Practicing since :2002

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