Our expert says:
Hi Shane, thank you for the question and my apologies for the delay with my answer.
Your first approach would be to use sun avoidance and a good SPF that contains zinc oxide and/or titanium dioxide to prevent the pigmentation from getting worse and to help prevent new pigmentation form developing.
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 (deep) or epidermal (superficial).
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. One may take a more aggressive approach and consider deep peels.
If the MELASMA IS EPIDERMAL one may try the topical treatments listed above together with the following:
Hydroquinone: prescription (4%) strength.
Tretinoin (Vitamin A), 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.
Pigment removal with laser (Fraxel, Ultrapulse) or IPL & Bi-Polar Radiofrequency (Syneron eMax, elight) or IPL (Ellipse) may also be considered.
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
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