Brief Answer:
Melasma; Sunscreen; Skin Lightening creams

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic

I am Dr. Kakkar. I have gone through your query.

I will keep a possibility of Melasma. Melasma commonly presents as hyperpigmentation over the cheek bones/malar area.
Other sites like dorsum of nose, forehead, upper lips etc may also be involved with melasma.
It is seen in both the sexes, males as well as females. It is more common in females but more intense or darker in males.
The pigmentation may vary in intensity from light brown to dark brown or even bluish.
It is idiopathic (no known cause) in most of the cases, specially males. Sunlight (particularly UV A light) has a major role to play.
However, there are a few well known causes of melasma in females specially, such as oral contraceptive pills, pregnancy.
Pain killers Or NSAIDs are implicated in both the sexes.

Sunscreen is an essential part in the management of any facial hyperpigmentation including melasma.
I would suggest you to use a broad spectrum sunscreen, throughout the day.
Reapply every 2-3 hours.
It should have both UV A as well as UV B coverage.
A broad spectrum sunscreen that has a minimum spf of 30, would be suitable.
You may find one such sunscreen OTC from a drug store Or you may also get it prescribed from a dermatologist.
Neutrogena dry touch ultrasheer sunscreen is available OTC (John & John) and can be used.

At night you may use a skin lightening cream. These creams contain one or more of the following active ingredients in various combinations e.g Tretinoin, Mometasone, Azaleic acid, Hydroquinone, Kojic acid, Arbutin, Glycolic acid, licorice extract, Niacinamide, Vit C etc.

The gold standard combination that is usually effective combines tretinoin, hydroquinone and mometasone (Kligman's formula).

Kligman's formula is the most potent combination for melasma and is usually recommended at the start of therapy Or in those in whom melasma is darker; other skin lightening ingredients like kojic acid, glycolic acid, arbutin etc are mainly used for maintenance of improvement.

These are all prescription products and I suggest you to visit a dermatologist in your region. Your dermatologist will tell you in more details about these.

Along with the creams, you may also opt for a few sessions of chemical peeling from your dermatologist.

Melasma may take time to respond and you have to be patient with the treatment and follow up regularly with a dermatologist. Your dermatologist might change or modify treatment according to the response.

Regards

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