Spot is spreading to a larger shape. I'm not going in the sun. Why is it spreading? Only a little darker. Melasma, PIH? (Photo)

Question

I just started using hydroquinone pads 4 percent 2 days ago. I avoid going outside. But I start school in July

Raffy Karamanoukian, MD, FACS · Answer

Melasma treatment takes a dedicated approach. Start with the Melarase Brightening Kit to help reduce your pigmentation an discoloration. If the melasma is severe, then you may also consider additional fractional laser. Best, Dr. KaramanoukianLos Angeles

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist. Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + brilliant, peels, microneedling/PRP, aerolase, and sometimes erbium laser (coollaser) to get the best results. Melasma will need life-long maintenance. Best, Dr. Emer

Hratch Karamanoukian, MD, FACS · Answer

It is a hyperpigmented area and I agree with the regimen of Melarase creams (AM and PM) which I use extensively in my practice as well as broad spectrum UVA and UVB protection with high sun block (SPF 50+) to prevent ongoing inflammatory injury from sun rays. I recommend Spectrase for this (see link). Also Scler-X PIH Relief complex can help with ongoing inflammation.

Zein E. Obagi, MD · Answer

HQ should not be used without the supervision of a dermatologist. It is important you get a formal evaluation with a dermatologist to determine if this is melasma, textural pigmentation, or PIH.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Hard to tell with that photo, I think you should see a dermatologist for a formal evaluation as melasma can be tricky to diagnose. Wood's lighting may also help. 
Melasma can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. 
  
I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I usually start my patients on laser (low dose Q switch or Picosure) a few weeks after they commence on creams. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams. 
  
In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient. 
  
All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia

Spot is spreading to a larger shape. I'm not going in the sun. Why is it spreading? Only a little darker. Melasma, PIH? (Photo)

Answers (5)

More Laser Resurfacing Questions

Which peel would be the best treatment for my melasma?

I'm 22 and have this birthmark in the middle of my forehead. I was wondering if there is any way to fade it. (Photo)

Does anyone what this is? Doctor confirmed it is not shingles, not coldsores not impetigo. Likely rosacea is their guess (photo)

Can Accutane improve Rosacea once finished? My Rosacea is the worst it's been! Very inflamed and burning.

My dermatologist told me self tanners will cause age spots to darken as well as create new spots on my face, is this true?

Gaping hole after laser removal of closed comedone, how long does this take to heal?

WE SEND PRETTY
EMAILS