Which procedure would help correct discoloration on the forehead? (photos)

Question

Discoloration formed primarily on my forehead in the past year or two. Wondering what treatment, such as chemical peel etc., or if a topical, like niacinamide would help? Looking for professional advice- thanks! I am in my early thirties

Barbara Padilla, MD · Answer

We recommend a chemical peel for hyperpigmentation spots. Chemical peels exfoliate the top layers of the epidermis and stimulate collagen production. We recommend 3 treatments 4-6 weeks apart. 
We also recommend the Obagi Nu-Derm system for hyperpigmentation spots. Hydroquinone is the active ingredient in this system. Hydroquinone is a depigmentation or skin lightening agent. This is effective for treating hyperpigmentation.

Raffy Karamanoukian, MD, FACS · Answer

Melasma discoloration is not treated like sunspots or normal hyperpigmentation because there is an underlying sensitivity to hormonal influences with melasma. You should uncover the hormonal influences with an expert (our office specializes in this) and then start with topical creams at home including Melarase AM and Melarase PM.

Avoid harsh lasers as they can make it worse.

Best,
Dr. Karamanoukian

Avoid harsh lasers as they can make it worse.

Best, 
Dr. Karamanoukian

Falguni Patel, MD, FACOG · Answer

VI Peel! VI Peel is a medium depth chemical that would help target discoloration. I would recommend VI Peel Precision Plus, about 3 to 4 peels spaced out between 4 weeks for best results!

Anna Chacon, MD, FAAD · Answer

Thank you for reaching out with your question regarding forehead discoloration. Based on your description and considering you're in your early thirties, there are several options that could potentially help improve the appearance of discoloration on your forehead. Here's an overview of some effective treatments:

Topical Treatments:

Niacinamide: This is a form of Vitamin B3 that can help improve skin tone and texture. It's known for its anti-inflammatory properties and can be beneficial in reducing discoloration.
Hydroquinone: This is a skin-lightening agent that can help reduce the appearance of dark spots and hyperpigmentation.
Retinoids: These are Vitamin A derivatives that can promote cell turnover and improve skin discoloration over time.
Chemical Peels:

Superficial Peels: These involve mild acids like alpha hydroxy acids (AHAs) that can gently exfoliate the skin and help with discoloration.
Medium Peels: These use stronger acids like trichloroacetic acid (TCA) and can penetrate deeper into the skin, providing more significant results for discoloration.
Laser Treatments:

Fractional Laser Resurfacing: This can target pigmentation and promote collagen production, leading to improved skin tone.
Intense Pulsed Light (IPL): This treatment can help reduce pigmentation and even out skin tone.
Microneedling: This treatment involves tiny needles that create micro-injuries in the skin, promoting collagen production and helping to improve discoloration over time.

Given the variety of treatments available, it's essential to consult with a dermatologist to determine the most appropriate option based on your specific skin type and condition. They can provide a personalized treatment plan to address your concerns effectively.

Christina Hector, DO · Answer

It may actually require a combination of both topical and chemical peel. It is best to be seen in an office setting to go over your daily skin care routine in order to make the best recommendations. I do however, recommend daily sunscreen as the UV light can potential make the discolorations dark.

Viva Eve Dermatology - New York · Answer

Hi!
This is a great question! It seems as though you are affected by a condition called melasma. Melasma is a lacy discoloration commonly occurring in the face, cheeks, and upper lip. Melasma is affected greatly by hormones, sunlight, and any heat energy and can be difficult to treat and maintain. 
First line options include general skincare that can be done at home. For example, one of the most important things is to always wearing sunscreen and protecting your skin from the sun, reapplying SPF every 2 hours, wearing a hat, and avoiding sun exposure. In addition to sunscreen, it is important to begin incorporating products into the skincare routine with medical grade ingredients that are targeted toward anti-hyperpigmentation and evening out skin tone, such as Vitamin C serums, discoloration serums, and gentle acids. These ingredients are to be incorporated slowly and with the care of a dermatology provider for proper use and follow up monitoring. 
Second line options include prescription topical lightening creams and chemical peels, at the discretion of a dermatology provider.
Third line options, after trials of the above two options, include laser peels to remove any remaining pigment, at the discretion of your dermatology provider.
Melasma is a condition that can recur easily and thus after treatment of the majority of the discoloration, maintenance peels and topical agents are generally required. Caution with sun and heat exposure is also imperative to keeping the melasma at bay.
As always, an in-depth, in person consultation is required for full evaluation and recommendations for your personalized treatment plan. 
Best,Eleni SgantzosBoard-Certified Dermatology PA