Lisa Zaleski-Larsen, DO, FAAD

Thank you for your question. Melasma is caused by genetic factors, hormones, and sun exposure. The most important treatment is to wear sunscreen 24/7 and to reapply in the daytime. Even indoor light can worsen melasma. It would also be helpful to wear a broad brimmed hat when outside. If you are taking any medications with hormones (birth control pills, etc) or if you are pregnant that can also worsen it. There are multiple topical medications that can help like hydroqinone cream, tretinoin, Kojic acid, etc that can be used. However, if you have 1 day of sun exposure it makes these medications useless. Some lasers like the NdYag can be used to treat melasma but it is possible to ask make it worse with a laser. Lower energy level lasers like clear and brilliant can be used for laser assisted drug delivery and can also help. I wish you the best.

Thank you for your question.  There are multiple possible causes for the color change under your eyes.

1. Juvederm is not the best filler for the tear trough.  I recommend Resylane or Belotero.  Juvederm can cause a bluish tint under the skin if injected superficially called the Tyndall effect.  Hyaluronidase injections could dissolve the Juvederm if the Tyndall effect is a concern.

2. Melasma is common on the face.  I recommend wearing a high spf sunscreen 24/7 because sun or even indoor light exposure can predispose you to developing melasma.  There are multiple topical creams that can lighten the skin (azelaic acid, tretinoin, hydroquinone) but if you have any light exposure it can make the topical creams less effective.

3. Seasonal allergies can cause dark circles under the eyes.  Claritin daily can help with this.

4. It is possible for a residual bruise to be present but it should have faded after a month.

I wish you the best.

Thank you for your question.  It is common for moles to change in pregnancy.  It is difficult to tell from the picture if a biopsy is needed or not.  I recommend keeping the appointment with your doctor to have a closer examination in person.  I wish you the best!

Thank you for your question.  The appearance of your biopsy site is normal.  Signs of infection would include pain, swelling, and tenderness.  If you develop these signs of infection I recommend for you to contact the doctor who completed your biopsy and inform them of your symptoms.  If you do not have these symptoms I recommend to apply a thin layer of vaseline twice daily until the area has healed.  

Thank you for your question.  It is hard to tell from the photo if it is a mole or something else.  I recommend for you to see a dermatologist to have a closer examination.  I wish you the best!