Posted by: Joy | 2008/08/05


I' ve got dark patches on my cheecks and forehead. They developed when i was pregnant in 2005. Presently i am using Johnson Fair Complexion Day Cream SPF15 and Johnson night cream but it seems as it does not help much. What can i use?

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Our expert says:
Expert ImageAnti-ageing expert

Hi Joy, thank you for the question.

Pigmentation is an over production of melanin (pigment) in the skin and may result directly from the sun or indirectly following trauma to an area or as a response to hormonal changes (this includes taking the oral contraceptive and pregnancy). To treat the pigmentation we need to establish what the cause of the pigmentation is as this will determine the treatment choice.

No matter what the cause of the pigmentation is always remember to avoid the sun as much as possible (use a hat) and always use an oil free SPF 30 or higher that contains zinc oxide and/or titanium dioxide (my personal preference is Heliocare SPF 50)

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.
Large pores respond well to glycolic or salicylic acid peels together with a good topical regime. You must only use oil free products and I will list the NeoStrata range as an example, however, one can find similar ingredients with Environ, Nimue, etc.:
NeoStrata Oil Free Lotion SPF 15, Oil Control Gel, and Clear Skin Solution.
Heliocare Gel SPF 50 (oil free)
Heliocare make an excellent range of compacts (foundation cover) that can be used as a SPF and is oil free.

So in summary, your best approach is to have the pigmentation 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.

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