Brief Answer:
Kojic acid or Azelaic acid can be used.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the pigmentation of melasma.

For melasma: it is pigmentation caused by multiple factors. Hydroquinone is one of the most effective medication for the same. The only concern is long term usage of the same.

In my patients I generally shift hydroquinone with other more safer creams which can be used for longer time without any problem. There are certain medication which safely helps out in reducing the pigment at these areas. If I were your treating dermatologist then would have prescribed a cream (under dermatological supervision) containing Kojic acid with arbutin and mulberry extract in it.

Alternatively Azelaic acid gel can be applied over the affected area of pigmentation. These are one of the best and safest creams to be applied. 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 also suggest you to use a good sunscreen for 3 times a day- once in morning and then every 3 hourly. Sunlight is one of the most important factor in aggravating the pigmentation of melasma.

Eat a good diet with lots of fruits of yellow and red color which acts as natural sunscreen.

I hope these informations will help you in getting rid of pigmentation marks.

I will be glad to reply any further queries. I wish best and early recovery,

With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology

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Brief Answer:
Use sunscreen for three to four times a day.

Detailed Answer:
Hello,

Welcome again to the forum and thanks a lot for your follow up.

Antibiotics in particular which you took are not at all related to melasma. So do not worry about the same. Some of the times certain antibiotics such as minocycline can cause photosensitivity and therefore melasma like pigmentation. But the pigmentation is temporary and do not remain for longer period of time in photosensitivity.

Stress can be an important cause of aggravating and inducing melasma. So do lot of driving can be very important cause as have lot of direct and indirect sun exposure.

So reduce your stress if any and do cover your face with a scarf or hat during driving along with sunscreen application.

As suggested before - use sunscreen for three to four times a day. It would be one of the most important factor in reducing the pigmentation.

I hope these informations will help you in managing of pigmentation of melasma.

I will be glad to reply any further queries.

With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology

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