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What Causes Light Colored Patches On The Right Side Of Face?

Posted on Mon, 30 Nov 2015

Question: I'm having pigmentations patched on face & neck. visibly darker compared to any other locaton of body. tried with several dermatologists in last 6 years but no solution yet. i had tinea versicolor fungus couple of years back.. doctors whom i visited so far are suggested to apply sunscreen and prescribed skin lightening night cream..which i have been using for years..but not finding any result..couple of doctors gave AF-150 tablets & cream also to reduce the fungus...But I'm not sure these patches are of sun/UV related or due to any reaction or due to fungus

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Need some clarifications

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have also reviewed the Images.

I can infact see that there are light colored patches on the righ side of face and they seem to be dry.
On the left side there seems to be some hyperpigmentation specially extending down from the temple. I would definitely like to rule out a fungal infection.
I would like to know are there any symptoms like itching??scaling?
What was the response to antifungal treatment? Can you upload a few more clear Images so that I can have a better idea?
Do you have itchy, scaly, patches elsewhere on body?

Thanks
Regards

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Kakkar (21 minutes later)

Thanks for your reply Doctor..

Yes...all these marks seem to be light patches on face and neck only..no where on my body have this kind of patches or pigmentation. There is no itching sensation at all..
I used antifungal creams & AF-150/400 tablets also..but no result in terms of getting rid of these patches & pigmentation. For your reference, I have uploaded few more images i have taken right now. you are right the skin looks dry as I havent applied any cream today as Im at home..generally i do apply sunscreen everyday during daytime and skin lightening cream in night times..

Answered by Dr. Dr. Kakkar (16 hours later)

Brief Answer:
Possibility of lichen planus pogmentosus; sunscreen and topical steroid

Detailed Answer:
Hi. I have reviewed the Images.

I can see pathes of pigmentation on face and neck. I will suggest a possibility of lichna planus pigmentosus (LPP).
Apart from using a sunscreen throughout the day I would suggest that you use a moderately potent topical steroid e.g mometasone furoate 0.1% cream (momate cream) once daily at night ONLY for the dark patches. Use it for 4 weeks initially and then follow up.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (58 minutes later)

Thank you for the diagnosis doctor... Yes i see the same as written in one of my previous prescritpions too.. since i don't see any result in last few years despite using daily sunscreen, today just before your message i thought of visiting homeopathy Dr.Batra.
So here exactly what you can suggest/recommend for me? also, please recommend a good sunscreen suits for my face with SPF?

Answered by Dr. Dr. Kakkar (5 minutes later)

Brief Answer:
Sunscreen and topical moderately potent steroid

Detailed Answer:
Hi.

Lichen planus pigmentosus is a slow responding condition.
In addition to sunscreen I suggest you to use a topical modertately potent steroid i.e momate cream, once daily at night, over black spots for 4 weeks.
You must use a broad spectrum sunscreen throughout the day. I suggest you to use either Sebamed sunscreen spf 50+ Or Neutrogena sunscreen spf 50+ throughout the day. Reapply every 2-3 hours.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (1 minute later)

I mean previous doctor also mentioned as LPP. also she recommend some steroid tablet CARTIPRED-8 (Methylpednisolone) to use if for one month. May I know your suggestion on using the same?

Answered by Dr. Dr. Kakkar (9 minutes later)

Brief Answer:
Only topical steroid

Detailed Answer:
Hi.

No. I wont ask you to take an oral steroid. Oral steroids have no role in LPP. I would just like to manage with a topical steroid.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (11 minutes later)

ok..thanks much... any recommendations on visiting homeopathy clinic?

Answered by Dr. Dr. Kakkar (29 minutes later)

Brief Answer:
I advice against homeopathy

Detailed Answer:
Hi.

I don't think that would be of any benefit.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (14 minutes later)

ok..thank you...as i observe slight/slow spread of this pigmentation over several months, do you recommend any other oral medicines? also, please suggest on soap/shaving/food/other habits to consider which might causes this LPP?

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
Oral hydroxychloroquin

Detailed Answer:
Hi.

Oral hydroxychloroquin can be considered for LPP which is widespread or spreading. LPP is more commonly seen in tropical countries where there is lot of sun and sun does seem to play a role in LPP, therefore the recommendation to use a sunscreen. Soaps, shaving, food etc don't have any proven role in induction or spread of LPP.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (10 minutes later)

ok..thanq..please suggest the dosage and when to take hydroxychloroquin pills?

Answered by Dr. Dr. Kakkar (20 minutes later)

Brief Answer:
Take hydroxychloroquin under supervision

Detailed Answer:
Hi.

The dose is 200 mg twice daily, morning and evening. It is a prescription drug and should only be taken under supervision of a doctor as it requires baseline and monitoring of liver function and eye check up.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar