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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Pigmentation On The Cheeks

Hi...I am 27 years old. I have developed pigmentation on the cheeks and nose. It came about 3 years back when I was on a crash diet...with nothing but water for breakfast n lunch. Now it s not going, even after visiting 3 different dermatologists. Infact the suggested creams darkened the normal skin wherever it touched. However, I have noticed that it has lightened a lot...from dark brown to light brown colour (2 shades darker than my normal skin) with just plain mosturier and lots of fruits/water/milk. But my concern is...it s spreading!!! How do I stop it? And I have noticed receeding hairline and greying. M drepressed and has taken a toll on my confidence. Please help.
Mon, 24 Nov 2014
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Dermatologist 's  Response
Hello. Thanks for writing to us at healthcaremagic

You have mentioned 2 concerns in your query:
-Pigmentation
-Receding Anterior hair line.

Your first concern is facial hyperpigmentation. You seem to have a condition known as Melasma. Melasma usually presents as light brown to dark brown or bluish pigmentation on cheeks, nose commonly and sometimes also on upper lip, forehead and chin.
Pregnancy, Oral contraceptives pills and Pain killers are well known causes. However, it is idiopathic in most cases.
Sunscreen is an essential part in the management of any facial hyperpigmentation including Melasma.
I would suggest that you use a broad spectrum sunscreen throughout the day. It should have both UV A as well as UV B coverage. Reapply every 2-3 hours.
A sunscreen that has a minimum spf of 30 or more, would be suitable.
You may find one such sunscreen OTC from a drug store Or you may also get it prescribed from a dermatologist.
At night you may use a cream, containing one or more of the following active ingredients e.g Tretinoin, Mometasone, Azaleic acid, Hydroquinone, Kojic acid, Arbutin, Glycolic acid, licorice extract, Niacinamide, Vit C etc.
Along with the creams, you may also opt for a few sessions of chemical peeling from your dermatologist.
Melasma may recur if sun protection is not strict and therefore sun screen is to be used even after the pigmentation resolves.
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.

Coming to you second concern of receding anterior hair line. This is likely due to Androgenetic Alopecia. Treatment is with Topical Minoxidil and Oral antiandrogens like finasteride in males and spironolactone in females.
I would suggest that you visit a dermatologist for a confimatory diagnosis and appropriate treatment for your hair fall

Regards
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Suggest Treatment For Pigmentation On The Cheeks

Hello. Thanks for writing to us at healthcaremagic You have mentioned 2 concerns in your query: -Pigmentation -Receding Anterior hair line. Your first concern is facial hyperpigmentation. You seem to have a condition known as Melasma. Melasma usually presents as light brown to dark brown or bluish pigmentation on cheeks, nose commonly and sometimes also on upper lip, forehead and chin. Pregnancy, Oral contraceptives pills and Pain killers are well known causes. However, it is idiopathic in most cases. Sunscreen is an essential part in the management of any facial hyperpigmentation including Melasma. I would suggest that you use a broad spectrum sunscreen throughout the day. It should have both UV A as well as UV B coverage. Reapply every 2-3 hours. A sunscreen that has a minimum spf of 30 or more, would be suitable. You may find one such sunscreen OTC from a drug store Or you may also get it prescribed from a dermatologist. At night you may use a cream, containing one or more of the following active ingredients e.g Tretinoin, Mometasone, Azaleic acid, Hydroquinone, Kojic acid, Arbutin, Glycolic acid, licorice extract, Niacinamide, Vit C etc. Along with the creams, you may also opt for a few sessions of chemical peeling from your dermatologist. Melasma may recur if sun protection is not strict and therefore sun screen is to be used even after the pigmentation resolves. 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. Coming to you second concern of receding anterior hair line. This is likely due to Androgenetic Alopecia. Treatment is with Topical Minoxidil and Oral antiandrogens like finasteride in males and spironolactone in females. I would suggest that you visit a dermatologist for a confimatory diagnosis and appropriate treatment for your hair fall Regards