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I will keep a possibility of Melasma.
Melasma presents as brownish
hyperpigmentation of sun exposed skin on face, particularly malar areas and nose.
Adequate sun protection is an essential part of treatment of melasma or any facial hyperpigmentary skin condition including Melasma.
The problem of recurrence is a common in patients of melasma.
The factors responsible being either inadequate sun protection or lack of maintenance treatment with a pigment lightening agent/cream.
The combination of
hydroquinone, tretinoin and
mometasone may be initially prescribed for 1-2 months and is the gold standard treatment for melasma and is usually the most effective out of all.
However, this combination is not meant for long term/regular use because of the risk of side effects related to steroid component of this cream (mometasone furoate) like skin thinning,
photosensitivity, acne &
hirsutism in females.
Therefore, once an effective response has been initiated with this combination, it should be sustained or maintained with other safer pigment lightening ingredients like
kojic acid, hydroquinone,
glycolic acid, Azaleic acid etc along with regular use of a broad spectrum sunscreen, throughout the day.
The treatment can be changed or modified according to response Or it can be combined with chemical peeling sessions e.g Glycolic acid peeling to produce additive results.
Regards