Problems with pigment on the face in Pakistan post laser.

Hi, I live in Pakistan where in summers the sun is at its peak , 50 degrees. Im 22 and i attend college , for that i do have to get some sun exposure during its peak hours. I do carry and umbrella and wear sunscreen religiously. About a year ago , i started laser around my chin and upper lips for hair removal. I bleached and experience round brown dark spots around the chin area , which dont seem to fade away. I have tried everything from meladerm to vitamin c capsules. Also i have GERD ( irriated stomach lining ) for which i cannot take vitamin c regularly. Please recommend me something, and a good sunblock that DOES NOT TAN, also some good brand skin lightening cream for the spots. Im pale , between nc 20 and 25. I dont tan or anything.I also have a bit of pigmentation issue around the cheek area.. Please please help me. I don't want my skin to go any bad. And yes i have stopped bleaching my face too. I dont anymore.

Thank you for writing/1   I really think this is a huge problem for women all over the world and that the pigmentation risks with lasers are not discussed enough.   That post hair removal laser pigment can usually be avoided by pretreating with certain topicals carefully, spacing the treatments out more and then using some hydroquinone (if tolerated) and, super sunscreens, of course.  It’s difficult to answer specifically for you because each person/case is so different.  More on pigment problems.

In general, here are some points to remember:

  • A high quality topical vitamin C has pigment regulating effects and would not involve the stomach.  Look for serums or gels in the 10-20% range.  
  • Retinoids – vitamin A creams – also help with this pigment as long as you are not outdoors much, sunscreen (see below) and don’t get irritated with them.  Start caustiously and work up to higher strengths. 
  • Everyone……..please always remember that about 10% of people get darker with hydroquinone creams, not lighter (due to irritation).  If that happens, it’s important to not use it.
  • The UV ray that matters the most for pigment is UVA (not UVB)!!  The only…… and I repeat only sunscreen ingredient that blocks UVA through the full UVA range is zinc.  Your sunscreen must contain at least 10-20% zinc.  I have melasma and I double (or even triple) layer two or three different zinc containing sunscreens every time I’m outdoors.  I use just one layer when I’m indoors.
  • Wide brimmed hats are also very helpful.   Most of the time you can’t see my melasma with good control (I developed melasma with my pregnancies).  
  • Really do try to see a good dermatologist, if you have one available in your area.

I know these products are expensive, but the better quality products just are expensive unfortunately.   If you can just afford 1 thing, buy the really quality hi-zinc sunscreen.  There are tinted, clear, lotion and powder options all on this site. 

I hope this helps,  Dr. I


Dr. Brandith Irwin, MD

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