Hydroquinone 10% + Kojic Acid 4% + Retinol 1% + Hydrocortisone Cream for Dermal Melasma - London, UK

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*Treatment results may vary

I have started this high strength cream for dermal...

I have started this high strength cream for dermal melasma on both cheeks and upper lip.
So far, nothing has worked for this pigmentation.
My dermatologist is of the opinion that high strenth cream should work!!
I don't know how hopeful I should be...

If anyone had luck with treating dermal melasma with similar high strength cream, please add comments I would really appreciate.

Since, this is my day 1, I would be going slow on this. Any irritation, I would stop using and then start using again. I will be moisturizing with dermol 500 lotion and would also wear vitamin c 20% serum with high spf in the mornings.

I realise that this is my last hope!! So, ladies, I need both your prayers and best wishes.
I will try and put updates as and when I start to see changes. I have plenty of before pictures which I will add later on along with after pictures.

Can I have a success story? I really wish I do...

day 1

it was really strong. i applied overnight. application areas are red and peeling. upper lip skin looks a bit darker. i will re-apply after redness goes away. planning to do 3 times a week, then more. bit scared that since its so strong, I shouldn't suffer side-effects. hopefully, redness will go away.

My plans if this treatment fails..

I have decided that this treatment will be my last at correcting the stubborn melasma. After this, I will be using vitamin c + retin a combo along with dermamelan maintenance cream only. I will fully focus on my diet, stress management, work and social life.
I know I can learn to cover up all my melasma nicely with makeup including the upper lip pigmentation.

I have been depressed over this since august. Left my job, cut off from the social circle and stopped dating as I was hopeful that I can find a right treatment.

But, all these harsh creams are very bad for my skin. I have decided that if this treatment failed, I will simply accept my condition as part of me and use makeup to look good.

Listen ladies, I know how hard it is to live with this condition, but I am sure when family and friends meet us they only notice our behaviour and happiness. At work, people associate with us for our capabilities mainly. Our partners will only love and support as long as we can give the same in return.

And, to avoid embarrassment, we can use makeup tricks!!

I would still stay hopeful that with going natural, maybe trying homeopathy, stress management, I will one day be all free to melasma.
But, I wouldn't see a derm again or ever again touch my face with any chemical/laser etc. I was a simple girl once upon a time, only used to get some facials done at a spa. Now my life is about chemical peels, and harsh chemicals. This can't be the right way to fix skin issues. I am sure it has to come from within.
Ladies, please comment if you find yourself at the same place. We can give strength to each other!!

Second application after 3 days...

I re-applied the cream today after last friday as face wasn't looking red anymore.
Would try to wipe it off early morning. Derm seems to be of the opinion that there won't be any side-effects but I am very scared as i don't want to ruin my face any further.

6th application tonight

I have used the cream sixth time tonight. I see no difference actually in the pigmentation.
It sometimes looks lighter and others bit darker.

I will still keep hope. Will give it another 3 weeks to see if any lightening is noticeable.

Day 7 - added Glycolic acid face wash to my treatment.

I am now using Glycolic acid face wash before applying the cream since it exfoliates and helps the cream penetrate better.
So far, no changes in the pigment but I also don't experience any flaking or irritation. My face gets red for a short period after application of the creams. Don't know if it's working TBH.
will keep updating.

Day 7

It's my day 7. No changes on the facial pigmentation. However, few spots on my neck have faded away. I am planning to start using a toner to balance the PH after the glycolic acid wash.

Am I hopeful, not really!! but, I have been asked to use this for six weeks and I will complete the course.

I don't have any side-effects at all. not even temporary redness which is good. But, I don't even peel at all. Don't know if this cream is working because derm had told me there will be lot of intial peeling. But nothing for me.

I use less than pea sized for cheeks and upper lip area.even that doesn't get absorbed easily..so, putting more cream won't be a good idea. I don't know why there is no peeling!!
But, I usually don't peel even when using retin a on it's own. So, maybe that's my skin's natural response.

In the mean time, I am already working on my next treatment plan. Have contacted few Ayurvedic doctors since Ayurveda claims to cure melasma at the root. They use herbal remedies, face masks and strict diet regimen to cure melasma from inside mainly. I will be on that treatment from Feb even if the current treatment worked because I need an internal cure and have few recommendations on both Ayurveda and Homeopathy. Anyone, who's tried everything else, look at either Ayurveda or Homeopathy. These are alternative medicines that claim to cure diseases at the root so that it never recurs.

Day 12-13, no change in pigment

I now use glycolic acid wash + plus mild toner before I apply the cream every night.Mornings I use Vit C 20% serum under my spf.
So, far I see no change in my pigment..

It's still emotionally hard to accept the upper lip pigment..
I don't wish to try anymore treatments after this..so, let's see if this works for me and if i am able to maintain results in the long term. What a struggle it is!!

22 or 23rd day on the cream last night!!

No changes in the pigment at all!! called up my dermatologist who told me that he expects to see improvements after 6 weeks, so seems like i am only half way through. I am also not too positive because doesn't it always come back after discontinuing the cream!! but derm said every one is different. if there are no internal triggers and i use strong spf, I should maintain results. and if some darkness comes back, i can use the cream for few days again.
Not sure how skin works and why my derm thinks that this cream can resolve my melasma and keep at bay!!

anyone, any comments?

25th day review

I think my upper lip pigment is bit lighter!! But, I am not satisfied and want it to lighten up considerably. There is also lots of drying and peeling still!! Makeup still doesn't look very good on face!! I am worried that with this condition, maintaining a normal well moisturised skin is going to be challenging especially around the mouth i.e. upper lip skin. Any comments on how anyone else make their face well moisturised will be appreciated? Also, very anxious at the moment, that even if pigment lightens up, It may be temporary!! very hard to keep applying cream especially on the upper lip skin as it dries up the face. Really hoping, there would be some way to easily maintain the face in the long term. I am also taking vitamin C, MSM, and grapefruit seed extract.I drink coconut milk and milk kefri drink regularly everyday. I have hopes that my skin can also heal internally. again, main pain is the upper lip pigment. If it goes away, I will be grateful to God.

Almost 1 month on the treatment, not much lightening so far!!

I complete the week 5 on the treatment and had taken about 7 days off the treatment in between. So, I complete 1 month today.

I think I see some lightening!! or maybe , I am getting used to of my pigment!! But, nothing close to complete clearance. I have few spots on my neck which remain unchanged.

I will continue with the treatment for another 4 weeks before seeing my dermatologist again.
I am struggling with makeup at the moment. Because of dryness and texture changes from dermalen peel, I think the current makeup doesn't match my complexion. It looks very rough and heavy on my face whereas earlier it used to look very natural.

I will wait till Feb end to announce whether or not this treatment has been a success for me.

Keep an eye ladies.

Not much lightening so far...feeling sad again today..

It has been already one month as per my last review, don't think there is much improvement!! It is the upper lip pigment that continues to bother me. It has affected my self esteem and I feel like a different person.

WIll update on weekly basis now. Also, still concerned about whether any improvements will be easily maintained or not. Upper lip is so central to ones face that it bothers so much!!

finishing 5th week on the cream tonight, only mild improvement in the pigmentation

I feel sad that despite being so diligent with the use of the cream, I only notice mild improvement in the upper lip pigmentation. it looks bit mixed up with the the skin above it but still few shades darker.
But derm said it takes six weeks so I will wait another 1 month at least before giving up.

The pigmentation on the cheeks has no improvement at all.
It's still very dry and peeling on the area of application. upper lip peeling so tough to hide as well..
I hope it improves in few more weeks and i don't have to apply this cream every night. That would allow me to apply makeup normally.

I have started applying vit c+ vitc E+ hyluaronic acid serum during the day to help the pigment further. My diet is still not great..
also, taking supplements to improve my insulin resistance since i may have a mild case of pcos which contributes to melasma. let's see if that improves my condition.

other issue is facial hair!! very scared to use bleaching cream or hair removal creams as my skin is very sensitive at the moment. not sure how to get rid of the facial hair? any tips welcome..
Will update next weekend now...

6th week on the cream...check before and after pictures..I think there is some improvement..let me know what you think?

Post six weeks review

First of all, I don't think my after picture is true representative of how my pigmentation looks at the moment. My upper lip skin is still 2-3 shades darker than the rest of the face and it does look bad. The pigmentation on the cheeks is a bit better.

I wouldn't rate this treatment a success because improvement in pigmentation is about 20-30% only. Even some dark spots on my neck are still there. Also, because of the strength of the cream, my face stays get dry and itchy. There is also redness which looks worse than the pigmentation.

I know for any patient, getting some kind of treatment is therapeutic and make us feel hopeful. But, I doubt that topical treatment have any effect on dermal pigmentation for the simple reason that pigment is persistent in the dermis and needs to be physically pushed out.

I would still continue to use this cream for about another month but only 3-4 times a week because I want my face to look nice with this continued treatment. On the days I won't use this cream, I will still be using the Vit C during the day and Retin A at night.

I am off to India for three weeks soon, and would meet some Ayurvedic doctor and learn about healing from inside using diet and herbs.

However, I do feel that I have to move on from this. In the last 4 months or so, I have done whatever I could do to get my face back and now I have to be realistic and accept what can't be changed.

I will write more reviews in the future possibly at 1 month mark. This treatment is likely to be discontinued in another 2 months when I will be looking at some non-hydroquinone based treatment.

I really hope that in the next decade or so, there will be new and more effective therapies available for melasma patients. I understand that some of us like myself, got melasma because of our own mistakes such as not wearing sunscreen, taking birth control pills or opting for laser on the face without doing enough research, but I still feel that there should be remedy available to fix the side-effects. At the moment, a lot of us feel trapped and regret making mistakes that resulted in pigmentation. Medical science has advanced so much but unfortunately skin conditions are not given as much importance as they deserve because of their harmless nature on the general health. Hopefully, there will be more breakthroughs in the future to effectively treat melasma. All the best ladies. I will keep updating on monthly basis or when I notice any improvements. Thanks

Latest picture to show upper lip pigment. Please comment.

Taking a break from treatment

My upper lip is really dry and sore. I am on a complete break from all treatment until my face recovers. I also think that there isn't really much change in my pigment. I have come to a realisation that dermal melasma is too deep for any creams to penetrate. But, I will still come back to using this cream for another 1 month.

Again feeling the pangs of regret over having laser done on the upper lip. I am trapped!! from a beautiful woman to an average woman, this transition has been tough!! can't tell you the kind of opportunities I have already lost. Feelings sad!!

I have stopped using the cream because it gave me lot of broken blood vessels...

I am in new delhi

Cream usage discontinued...treatment failed!!

I have stopped using the cream due to developing broken blood vessels. I am in Delhi,India at the moment and exploring new treatments. I am also working on accepting that thee may not be any effective treatment available for dermal melasma. The high strength cream is unsuitable for my sensitive skin and I was constantly flaky and red. I don't think I got any improvement as well. I would never use any steroids on my face now. I am evaluating PRP and nanotechnology at the moment. I may also try Ayurvedic treatments because they have minimal side effects.

Second round on this cream started yesterday i.e. 12/04/2016

I had used the cream for 6-7 weeks till 11 Feb 2016. I had persistent redness and sore skin. A dermatologist in Delhi gave me a diagnosis telangiectasia. I was scared of further damaging my skin so stopped using the cream. I also didn't notice any fading mainly because of persistent redness.

However, after stopping the cream within 1-2 weeks my skin recovered and I noticed that my pigmentation had lightened. That's why I have now decided to try it again for six weeks. Hopefully it's safe to do so since I have given a 2 months break already. Luckily my pigment is still lighter, hopefully I will maintain the improvements I have made and I will make in the future.

Looking to meet a new dermatologist in London too to ensure it's still safe to use the cream. On research I discovered , that telangiectasia develops mainly due to use of steriods in creams. However, this cream has very mild steriod. So, it's a good formulation.

It's important to note that I am also using ayurveda treatment + naturalpathy to help my skin from within. I take two medicines that contain high percentage of purified sulphur, calcium, iron, and very strong blood purifier with strong detoxifying effect. I also use hydropathy where I give steam to face for 5-10 mins, then sit in cold water for 12 mins, then wash face with cold water , and then work out by running for 15-20 minutes. I also take a medicine with it that's mainly made from plaster of paris( calcium). I have been very deficient in Calcium, Vitamin D and RBC count. That means that ayurveda doctor is doing the right treatment by giving me high dosages of these minerals. I have a lot of faith in this treatment. But, I want to help my skin externally too for faster results. I think ayurveda treatment will cure my melasma from inside and I may no longer have any sun sensitivity afterwards. I am looking at six months or longer on this treatment. But, I have lots of confidence in the treatment.

So, I will use both of these treatments till mid June now. And, will update everyone with results. My skin is already better with lighter pigment, and nice glow.

I am praying to God that I will maintain these changes ( which i should since I used no lighteners in two months still pigment stayed the same), and get much clearer skin soon.

Will keep you updated on monthly basis now.

Discontinued the cream for good

I have developed broken blood vessels during my last trial on the cream. That's why I have decided I won't use hydroquinone on my face ever again.
Currently, I am on Ayurveda treatment and will stick to it for the rest of this year. It may be taking time to show results but it has allowed me to improve various aspects of my life such as sleep, stress management and diet. I will stick to for the rest of this year. Giving melasma 1 year using this therapy is not a big price to pay if I get my normal face back. Hopefully, it does deliver results. Will update in few months how it's going. Thanks

Major diet overhaul along with ayurveda herbs and hydro therapy

I have been following dr jack kruse's recommendations for melasma and have made following dietary n lifestyle changes. 1. I get up early morning at 6 and have heavy breakfast full of protein n fats. Then I go out in sun n sit n relax for half an hour outdoors. 2. I come back n take shower starting from warm to cold and then ending with warm. 3. My diet now includes oysters , fish for healthy dha, avacadoes n humous , mct oil , cocunut oil for healthy protein n fats. I only eat spinach n lentils n one peace of carb a day. So its high protein n high fat diet with no sugar at all. 4. I apply mct oil directly to my face too. 5. No use of indoor lights during the day. This is in addition to my ayurveda treatment. That is basically providing me supplements in herbal form. Dr kruse thinks this is the right way to cure melasma. I will try atleast till the end of this year. It's only few days on this routine now but I will stick to it till dec n then re-analyse. Hope it works for me.I want to fix this condition 100% and also become a healthier person. Great learning about eating right n staying close our natural self by sticking to circadian clock and nature.
Dr Sunil Chopra

So far, very professional and knowledgeable. I need to see if his skills, knowledge and experience gives me relief from this dreaded condition. I would add generous reviews if I benefit. I am willing to make him my GOD!!

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