Q: Dermatologist, I have been diagnosed with Melasma on my arms, shoulders, and neck. The discoloration is worse on my arms and shoulders. Most products are for Melasma on your face. Would your products treat Melasma on arms, shoulders, and neck? Which products do you recommend? I live in Florida and enjoy an active lifestyle. When I am outdoors, I always use a sunscreen. Would you also recommend a good sunscreen? 

A: This is a large affected area. Consider Glytone Fading Lotion twice daily followed in the mornings and often when outdoors by Blue Lizard Sunscreen.

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Q: I have some pigmentation or discoloration on my face. What will work to clear this up? 

A: Bionic Skin Lightening Cream SPF 15 by NeoStrata that combines PHA, hydroquinone and sunscreen so that one application twice daily is all that is required.  

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Q: I had a baby 3 years ago and since her birth, I suffer from heavy pigmentation above my upper lip. I was told the condition would resolve in a "few months" following delivery. What do you suggest?  

A: Consider Exuviance Intense Lightening Complex, M.D. Forté Skin Bleaching Gel or Glytone Fading Lotion twice daily. Broad spectrum sunscreen such as M.D. Forté Environmental Protection Cream SPF 30 is also important. Optimal results will take four to six months and are dependent upon careful sun avoidance as well as treatment.  

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Q: I am currently using Retin-A and Obagi skin lighteners to control and correct melasma on my face. My skin is oily and my biggest problem seems to be finding sun protection that is not greasy and does not cause breakouts. Would you consider the SPF 20 in the Jane Iredale Mineral Makeup to be sufficient protection for a normal workday going back and forth to the office? Thanks for your help.  

A: Yes, this proposal for work day sun protection is appropriate. 

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Q: I have hyper pigmentation spots around lips and in the chin. I am Asian & dark complexioned. Can you please advise a product suitable to me. 

A: Consider M.D. Forté Skin Bleaching Gel or Glytone Fading Lotion twice daily. Optimal results will take four to six months and are dependent upon careful sun avoidance as well as treatment. A broad spectrum sunscreen such as Solbar 50 (better for darker skin types) is necessary as well. 

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Q: Question about Pigment Relief: I have been using a product for about six weeks, and I haven't noticed any signs of improvement. I have some light pigment spots after pregnancy (I am 31 years old) and they don't seem disappearing at all. My skin care regimen is: Cleansing, toning, Pigment Relief (twice a day) and a moisturizer. I wait several minutes before applying Pigment Relief. I bought this product from Dermstore.com about two months ago. Can you please tell me what might be wrong with using this product? 

A: With melasma, results vary even when products are used properly. Generally speaking, however, results are best with products that contain hydroquinone. If you are considering trying something stronger, have a look at Exuviance Intense Lightening Complex, M.D. Forté Skin Bleaching Gel or Glytone Fading Lotion twice daily. Don’t forget a broad spectrum sunscreen as well. 

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Q: I have melasma on my upper lip. What would be the best treatment for me? 

A: Kinerase may be applied once or twice daily after hydroquinone products and before sunscreen. Optimal results will take four to six months and are dependent upon careful sun avoidance as well as treatment.  

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Q: I'm wondering if hydroquinone or benzoyl peroxide can cause cancer? What product do you recommend for lightening previous brown spots due to blemishes? If hydroquinone causes acne can you please suggest me a product without hydroquinone?

A: There is no data to suggest that these substances cause cancer in humans. Hydroquinone is not a common cause of acne. Have a look at this article that I wrote on melasma. M.D. Forté Skin Bleaching Gel or Glytone Fading Lotion twice daily. Broad spectrum sunscreen is also essential. A prescription retinoid such as Differin or Tazorac might also help. Optimal results will take four to six months and are dependent upon careful sun avoidance as well as treatment.  

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Q: Is there a permanent cure for melasma (chloasma)? If it is then what product can be used or what can be done to cure this condition. Please could you help me here because I am 35 of age and suffering from this condition and the result to this is upsetting me and causing stress. Thank you for the help. 

A: There is no perfect cure for melasma. Both OTC and prescription products are available to help treat the condition.  

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Q: I'm 25 and have been in the sun my entire life and have damaged my skin. My skin is sensitive and gets red easily. I also have some acne scars. I would like to restore my complexion. What is the best product? Kinerase, Skinceuticals, etc.

A: For melasma, consider Exuviance Intense Lightening Complex, M.D. Forté Skin Bleaching Gel or Glytone Fading Lotion twice daily. Broad spectrum sunscreen such as M.D. Forté Environmental Protection Cream SPF 30 every morning is also important. Kinerase may be applied once or twice daily if desired after hydroquinone products and before sunscreen. Optimal results will take four to six months and are dependent upon careful sun avoidance as well as treatment. NeoStrata offers another approach to treatment, Bionic Skin Lightening Cream SPF 15. This product combines poly-hydroxy-acid, hydroquinone and sunscreen in one product so that only one application twice daily is required. As a face wash, consider M.D. Forté Facial Cleanser II twice daily. For local breakouts, consider M.D. Forté Glycare Perfection Gel as a spot treatment once or twice daily as needed. For the dilated blood vessels, consider consultation with a dermatologist.

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Results vary with these products even when factoring out compliance issues.