Posted by: Michelle | 2008/07/15


I am 41 years old with pigmentation on my cheek and jawline area. I use a sunblock every day and try to cover up when in the sun. I have just purchased a Derma Wand which I am using 2x daily and would like to find out what more about Renova cream which derma wand recommends or should I rather go for Regima peels. I have to cover up with a foundation everyday as my face is badly scarred and marked and I feel yeeick. The skin care salon recommends skin peels and I'm afraid it could cause further damage. I wash with dove soap and use African Extracts Rooisbos night, day and eye cream. I have always looked after my skin and this started at around the age of 38 which could be from the pill and the pregnacy. How can I get my face like it was before .Will the Derma Wand help . Or does this come with the age and our climate. I am on no HRT.

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Our expert says:
Expert ImageAnti-ageing expert

Hi Michelle, thank you for the question.

Your best approach would be to consult a dermatologist, or aesthetic practitioner, that can examine the areas that concern you and advise you on the appropriate treatment options.

I am not 100% sure what has caused the scars you mention or what they look like and how severe in depth they are. As a generalization the treatment regime I will list for the pigmentation treatment (see below) will have some effect on the scarring as well. If you would like a more in depth answer regarding your scarring, please post another question and we can go from there.

If the pigmentation has been caused by SUN DAMAGE only, you have several choices for treating the areas of concern:
Glycolic acid peels and mandelic acid peels (these 2 may be used in combination).
Topical creams – should contain glycolic acid, mandelic acid, vitamin A, vitamin C, kajoic acid, mulberry root extracts, and one may even consider adding hydroquinone (2% or 4%). This is a long term option and you will only start to see some improvement within 2 to 3 months of consistent use.
The NeoStrata range contain all of the ingredients listed above but one may find them in combination in one form or another with Environ, Nimue, etc.:
NeoStrata Complexion Gel
NeoStrata Brightening Cream

Skin rejuvenation – laser or IPL based machines specific for pigment removal can be used. The pigment removal is usually faster than creams and in some cases, only 1 session is required.

HORMONAL CHANGES that produce pigmentation is known as Melasma or Chloasma, and typically forms on the cheeks, upper lip, forehead, and less so, on other parts of the body. If the pigmentation you see is Melasma the treatment becomes more difficult, as one needs to differentiate if the pigmentation is dermal or epidermal.

If the Melasma is dermal, laser or IPL will actually DARKEN and worsen the appearance of the spots.
DERMAL MEALSMA is generally unresponsive to most treatments, and has only been found to lighten with products containing mandelic acid. So your best approach would be to use a combination of glycolic and mandelic acid peels together with topical products containing mandelic acid.

If the MELASMA IS EPIDERMAL one may try the topical treatments listed above together with the following:
Hydroquinone: prescription (4%) strength.
Tretinoin, an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy.
Azelaic acid (20%), thought to decrease the activity of melanocytes.
Facial peels with alpha hydroxy acids (mandelic) and/or glycolic acid.

Regim A peels use lactic and malic acid as their main ingredients and my concern with this peeling system in regards to the complaints you have is as follows:
Very little evidence (in the form of studies) that verifies the exact effectiveness of malic acid with pigmentation and scars.
There is a greater bulk of evidence in the effectiveness of glycolic acid (with scarring and pigmentation) when compared to lactic acid.
In essence I do not believe that the Regim A peels will do any harm to your skin but depending on the severity of your concerns one may have to mlook at another form of peeling system.

Please go to my web page at: and search Dermawand as there is a good summary of this product and reports from a few consumer review web pages.

So in summary, your best approach is to have the pigmentation and scarring examined, and from there to decide the treatment regime. However, there is nothing stopping you from trying the topical approach first.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

Our users say:
Posted by: Anonymous | 2015/11/08

Hi I have pigmentation under my cheek with dark skin , its this all about age couse im taking care of my skin. Im 40 yrs old hiding it with foundation every day . What products must I use couse nw im using sun screen

Reply to Anonymous
Posted by: Anonymous | 2014/05/31

I have pigment ratio on my cheeks..I been using advantane cream and I'm 24yrs old...what can I use to get rid of my pigmentation

Reply to Anonymous
Posted by: Dr Alek Nikolic | 2008/07/19

Hi Michelle

Please submit your second question on the main forum as any one can post a comment and this does not ensure the security of the answer. I can also miss these comments as they do not appear directly on my admin side of the question and answer panel. So please click the Back to Forum button and then the Submit a Question button. Sorry to ask you to resubmit but unfortunately it is necessary.

Reply to Dr Alek Nikolic
Posted by: Michelle | 2008/07/17

Thank you for the reply. I have used environ about 6 years ago but then went over to the rooibos range. The dermatologist also gave me 4% hydroquinone mixed with aqeuous cream which i used for 2 months but made face very red and sensitive. He then said I should not worry as the pigmentation does not look too bad, but has got worse over the last year. The therapist said it is hormonal known as melasma and I feel embarassed to go anywhere even to the gym without covering up with foundation, the marks seem to go red during the day and by mid morn needs to be covered up again. I even tried 6 weekly treatments of micro derabrasions which did make the face lighter, but once I stopped the marks came back. The left side seems worse than the right side which I think could also be from driving in the car. I would say it is sun damage and pigmentation even though I use dermopal daily (30spf). The NeoStrata gel and cream I see comes from the USA. Is it available at the Dr' s rooms only and is it an expensive product to use. Has SA not got a product equivalent to the NeoStrata range. What sun block do you recommend for the South African climate for anti ageing.

Reply to Michelle

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