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Suggest remedies for pigmentation on face

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Posted on Fri, 20 May 2016
Question: Hello Doctor. I am 35 years old and I have observed that my skin is pretty sensitive to sunlight. There is a a small area on my face where I have developed some pigmentation, I have attached a picture to give you more insight.
After consulting a dermatologist a few months ago I have implemented the following methods to reduce the pigmentation.

1. I apply photobloc (spf 50) every day three times, even when I am at home to prevent exposure to uv rays.
2. As per the dermat's recommendation I apply Kojivit plus every alternate days in the night before sleep, and on other days I apply Ban a tan cream in the night before going to bed.

I have done this for about three months now but I am not seeing any visible changes. I am afraid that the pigmentation is becoming more prominent.

Can you please recommend what I should do to completely get rid of this?

Regards,
XXXXX
doctor
Answered by Dr. Kakkar S. (49 minutes later)
Brief Answer:
I suggest a kligman formula based cream for initiation of treatment

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar(dermatologist). I have gone through your query and i have also reviewed the image.

You seem to have Melasma, a condition which presents with asymptomatic brown patches on sun exposed skin of face.

You may use a cream triple drug combination i.e based on Kligman formula e.g tretinoin+hydrquinone+hydrocortisone in addition to the sunscreen. This formula/combination is preferred for initiation of treatment in melasma and usually produces good results in most patients in about 2-3 months. Thereafter this combination cream based on kligman formula is changed to a milder preparation like kojivit or ban-a-tan (those which you are currently using) for maintenance of improvement. Sunscreen use is a must for these to be effective.
Creams based on kligman formula/ modified kligman formula are prescription products and should be used under supervision of a dermatologist because they can cause irritation. In any case these creams should not be used longer than 2-3months because they are steroid based. However these creams based on kligman formula are effective for initiation of treatment in melasma because of dramatic and excellent impoivement in melasma.

Regards
Above answer was peer-reviewed by : Dr. Deepak
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Follow up: Dr. Kakkar S. (22 hours later)
Thanks Doctor. Could you please provide me with the name of the cream and the dosage?


Hello Doctor, I did not see a response for my previous question. Can you also let me know if a lazer treatment would be a better solution to my skin condition? If that's a faster healing process then I could consider that.
doctor
Answered by Dr. Kakkar S. (23 hours later)
Brief Answer:
Sunscreen during the day and depigmenting cream at night

Detailed Answer:
Hi.

I apologize for some delay in my reply.

You may use Sebamed sunscreen spf 50 during the day. Reapply every 2-3 hours. At night you may use Clearz XXXXXXX Or Lumacip plus or Triglow M cream, only at the pigmented patch. All these creams are based on kligman's formula. However, you should not use these creams for more than 2-3 months. Once the initial response has been achieved with one of these creams should be substituted by an safer alternative like kojivit or ban a XXXXXXX cream (those which you are already using now)

There is no laser treatment that works for melasma.

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

Dermatologist

Practicing since :2002

Answered : 9009 Questions

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Suggest remedies for pigmentation on face

Brief Answer: I suggest a kligman formula based cream for initiation of treatment Detailed Answer: Hello. Thank you for writing to us I am dr.kakkar(dermatologist). I have gone through your query and i have also reviewed the image. You seem to have Melasma, a condition which presents with asymptomatic brown patches on sun exposed skin of face. You may use a cream triple drug combination i.e based on Kligman formula e.g tretinoin+hydrquinone+hydrocortisone in addition to the sunscreen. This formula/combination is preferred for initiation of treatment in melasma and usually produces good results in most patients in about 2-3 months. Thereafter this combination cream based on kligman formula is changed to a milder preparation like kojivit or ban-a-tan (those which you are currently using) for maintenance of improvement. Sunscreen use is a must for these to be effective. Creams based on kligman formula/ modified kligman formula are prescription products and should be used under supervision of a dermatologist because they can cause irritation. In any case these creams should not be used longer than 2-3months because they are steroid based. However these creams based on kligman formula are effective for initiation of treatment in melasma because of dramatic and excellent impoivement in melasma. Regards