Brief Answer: Kindly send details with high resolution pictures Detailed Answer: Hi, Welcome and thanks for posting your query to healthcare magic. I can understand your concern towards pigmentation in you and your daughter. Before I can answer your concern can you please take pains in letting me know certain important information regarding the pigmentation (kindly tell individually for you and your daughter): 1. Since how long you and your daughter have pigmentation. 2. Do you or your daughter feel any burning or pain or itching sensation over the areas. 3. If you feel burning or pain or itching, then is it mild/moderate/severe. 4. Any treatment take for the same. It would be best to send few good resolution pictures of the area yourself and your daughter so that it can be analyzed best. You have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your queries better. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia). "Wish you good health" with regards, Dr. Sanjay Kumar Kanodia (MD - Dermatology)

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Brief Answer: Melanosis; apply kojic acid; sun protection Detailed Answer: Hi, Welcome again to the forum and thanks for posting the details along with picture. There are two important factors involved in the pigmentation of these areas: 1. Genetical Melanosis: The pigmentation at the facial areas is genetically determined. To tell you simply, the darkness is due to the activity of melanocytes in the skin. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. This is a tendency in ourselves to get higher activity of these melanocytes at the facial area according to our genetic make up. It is seen on higher side in people of Asiatic origin than in white population. 2. Secondly these areas are further darkened by the process known as "Post inflammatory hyper-pigmentation" or PIH. The facial area is prone for sun damage and it causes over production of melanin in the skin. This pigmentation is known as "sun tanning". As facial area is quite sensitive so we can not apply any cream which is available over the counter as can cause burning and further aggravation of the condition. I can see you have applied zincoderm, deriva -cms, sorfyl-s. Zincoderm is a strong steroid, and sofryl-s also also contains calcipotriol & betamethasone which is again a steroid and are never used in the above condition and never on face as it can cause side effects. Deriva cms contains adapalene and clindamycin which are actually medicine for pimples rather than pigmentation. So none of your medicines are effective in your condition. I doubt whether these are prescribed by a proper dermatologist. There are certain medication which helps out in reducing and reducing the pigment in short period of time. 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. Sun protection is a must and a proper sun screen should be used. Diet is also quite important in reducing the pigmentation. Good diet not only helps in renewing the skin better as well as works best to protect our skin. You can eat a lot fruits and green leafy vegetables in your daily schedule. 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: Kojic acid and Azelaic acid as suggested Detailed Answer: Hi, Any of the creams should be used dermatological supervison only so tha tany of the chances of side effects can be reduced to mimnimal ( most of the times mild to moderate irritation). If I were your treating dermatologist then would have prescribed a cream containing Kojic acid with arbutin and mulberry extract (such as Clearz ultra). Azelaic acid gel if used teh should be started with low percentage (Aziderm 10%) and then can be increase to higher percentage (Aziderm 20%) after few weeks of time. All these creams are to be applied 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. A pea size amount is sufficient to be applied to palm size area. A good quality sunscreen is also a must in day time. I hope these informations will help you. I will be glad to reply any further queries or if not then can close teh query and rate the answer. With regards, Dr Sanjay Kumar Kanodia MD- Dermatology

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