Hyperpigmentation on cheeks due to sun exposure while using Tretinoin: Treatment? Is this Melasma?

Question

2 years ago i began using Tretinoin as part of my evening skincare routine. I now realize this made my skin very sensitive to the sun. The only sun protection i used was BB cream with SPF 20. As a result i developed hyperpigmentation on my cheeks. Question: How should this condition be treated? Should i use Kligman compound (hydroquinone+tretinoin+steroid) similar to treatment for melasma? Or can i use IPL or Fraxel?

Raffy Karamanoukian, MD, FACS · Answer

Melasma and age spots can be due to hormones, aging, sun exposure, thyroid dysfunction, and genetics. Treatments range from IPL to laser therapy; but pigmentation may recur if not complemented with topical creams to stabilize the pigment cells. 
  
I would suggest starting with Melarase Brightening Kit with Melaclenz, Melapads, Melarase AM, and Melarase PM to help stabilize pigmentation and reduce recurrence. Once started, an active protocol that includes Covalent peels, IPL, fractional laser, and microneedling can further remove pigmentation,. .
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Robert T. Buchanan, MD (retired) · Answer

What you have is essentially melasma. There are several ways to treat it. One is use of hydroquinone. This does work in medication like you mentioned, but this is not the best way to go. First, the steroid should not be used for long periods. Secondly, they take an exceptionally long time to work. An IPL set properly can also treat these areas. They, however, only treat the pigment temporarily and nothing else. I believe that the best way to deal with a problem like yours is use of the Obagi Nu-Derm System. It also contains tretinoin and hydroquinone, but additionally contains other products to fully rejuvenate your skin and works much more quickly and thoroughly. It also uses a zinc oxide sunblock that actually blocks UVA well, something no non sunscreen with an SPF (indicating it blocks UVB) can do. It is UVA that causes problems like yours, not UVB. See a physician with significant experience in skin rejuvenation.

Hyperpigmentation on cheeks due to sun exposure while using Tretinoin: Treatment? Is this Melasma?

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Hyperpigmentation on cheeks due to sun exposure while using Tretinoin: Treatment? Is this Melasma?

Answers (2)

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Everything you need to know about Retin-A

Our mission is to create a world where every investment in modern beauty is Worth It.