You likely have melasma...

Bryan K. Chen, MD answers: Treatment for facial brown spots?

Over the last 1-2 years, I have developed two brown patches under my eyes, one large patch on my forehead and one on the top of my nose. After being told this may be caused by starting oral contraceptives 2 years ago, I stopped taking them about 6 months ago but not have seen the brown patches fade. I'm 29 and don't get much sun except an annual cruise and I always wear a hat and sunscreen on those trips. I wear an SPF15 sunscreen moisturizer every day. What are these, and is there anything I can do to get rid of them?


Bryan K. Chen, MD
10 months ago

...but since there are numerous conditions that can mimick melasma, I suggest you be evaluated by your local dermatologist. 

Melasma, a genetic and hormone-related condition is worsened by sun exposure.  I would advise a daily moisturizer with SPF 30 or greater.  Another great alternative containing a tinted cover-up make-up and zinc oxide is a product called Colore Science Sunforgettables, available online.

Besides strict sun protection, other interventions that can help:

1. hydroquinone ("bleaching" creams)

2. light chemical peels such as Jessners, sal acid and 10% TCA

3. Intense Pulsed Light ("photofacial")

4. Fraxel re:fine or re:store lasers.

The caveat is that if your melasma is successfully treated with any or a combination of these treatments, it tends to come right back if you do not protect yourself from the sun.

Good luck.

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