Brief Answer:
Kindly send pictures of the affected area.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the pigmentation at various areas and the problem of keratosis pilaris.

Pigmentation varies in its grade and acceding room darkness and various areas of concern we recommend various solutions.

In view to help you best I request you to kindly upload few good resolution pictures of the affected area focusing the area of concern. For the same you have a feature on the right side of the page. Kindly mention each area so that accordingly I can guide you best.

Tell me do you feel any itching or irritation over the area of keratosis pilaris.



Hope to hear soon from your side.

With regards,
Dr Sanjay Kanodia
MD-DERMATOLOGY

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Brief Answer:
Genetical Melanosis with PIH: treatment options

Detailed Answer:
Hi,

Welcome again to the forum and thanks for posting the details along with picture.

I am highly thankful to you for taking pains in sending all the related pictures. I have gone through all the pictures and after analyzing each one I can get that the pigmentation is quite deep at the groin area as well as at the arms.

There are two important factors involved in the pigmentation of groin and buttock region:

1. Genetical Melanosis: The pigmentation at the these areas is genetically determined. To tell you simply, the darkness is due to the activity of melanocytes in the skin. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. This is a tendency in us to get higher activity of these melanocytes at the facial area according to our genetic makeup. It is seen on higher side in people of Asiatic origin than in white population.

2. Secondly these areas are further darkened by the process known as "Post inflammatory hyper-pigmentation" or PIH. The groin and buttock area is prone for friction and it causes over production of melanin in the skin. This pigmentation is known as " Post inflammatory hyperpigmentation" or PIH. ".


For the area of arms the same PIH is the main cause as after the healing of the lesions there is formation of pigmentation at these areas.

As the groin and buttock area are quite sensitive skin so I don’t prefer to use chemical peeling at first instance. There are certain medication which safely helps out in reducing the pigment at these areas. If I were your treating dermatologist then would have prescribed a cream (under dermatological supervision) containing Kojic acid with arbutin and mulberry extract in it.

Alternatively Azelaic acid gel can be applied over the affected area of pigmentation. These are one of the best and safest creams to be applied. Apply any of these creams in a very thin layer at night time only so that these should not be visible to naked eye. Apply at night time before sleeping.

For the arm area topical cream with Hydroxyquinone 2% and salicylic acid 1.5% are quite fine and can be used safely. Again I want to mention that apply the cream in a very thin layer at night time only so that these should not be visible to naked eye. Salicylic acid should not be used at groin and buttock area as are moist areas so can cause severe irritation and burning. Hydroquinone on the other hand can cause rebound hyper-pigmentation at groin area due to same irritation potential.

If the creams are not giving adequate results in 3 months then I prefer to go for glycolic peeling with low concentration. Around 6 peeling sessions at a gap of 21 -28 days gives good results along with topical medications.

I additionally suggest you to avoid friction and synthetic clothes which can cause increase pigmentation at both sites.

I hope these informations will help you in getting rid of pigmentation marks.

I will be glad to reply any further queries. I wish best and early recovery,

With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology

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Brief Answer:
Pigmentation problem: Start with Arbutin

Detailed Answer:
Hello young fellow,

Welcome again to the forum and thanks a lot for your follow up.

I have gone through all the links provided by you. If I were your treating dermatologist then would have first started with XXXXXXX France Tone Perfecting Creme. It basically contains Alpha Arbutin and Niacinamide which are quite very safe and have non- irritation potential. You can use the same cream for around 8 weeks to see the results.

If at all you find that results are less then you can shift to Meladerm cream which has additional Kojic acid and other contents. Additionally the former cream is milder than Meladerm cream so better to start with previous one first. I also suggest you to apply the cream in minimum amount. A rule of thumb is a pea size amount on finger tip ( 1 gm) is sufficient for palm size area of skin.

Other of the suggestions are as in previous mail.

I hope above information will help you. I will be glad to guide you any further or if not then can close the discussion ad rate the answer.

With regards,

Dr Sanjay Kanodia

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