Struggling with Stubborn Hyperpigmentation? Get Expert Solutions Now!

Struggling with Stubborn Hyperpigmentation? Get Expert Solutions Now!
Published on, 04 June, 2024. Answered by Dr. Anna Chacon and Verified by Dr.Galen Team
Patient Question

Hello Doctor,


I've noticed hyperpigmentation on my forehead, and I suspect it might be melasma. I've already undergone 4 sessions of microneedling and 2 yellow peels, in addition to using azelaic cream and HQN for the past 3 months. Despite these efforts, the condition persists. Are there any other treatments you would recommend? I've heard about Crystal Tomato, Cosmelan, and glutathione. Can you advise on the best option for my brown skin?


Answered by Dr. Anna Chacon


Thank you for reaching out to Dr. Galen. Please find the below response to your query.


Hyperpigmentation can stem from various causes, and it's essential to identify the underlying issue to determine the most effective treatment. Based on your history, it's likely that you're dealing with melasma, a condition known for its challenges in management. 

Your current treatment regimen, which includes microneedling, yellow peel, azelaic cream, and HQN, is a commendable start. Consistency is key, and it's important to continue these treatments for at least six months or longer to achieve optimal results. 

Regarding the additional treatments you've mentioned, let me provide some insights. Crystal Tomato is considered a suppressive therapy for melasma and other pigmentation disorders. However, it's crucial to note that the evidence supporting its effectiveness is somewhat limited. 

Cosmelan, on the other hand, offers a combination treatment approach, utilizing both a peel and a depigmenting agent to address pigmentation concerns. This treatment has shown promising results in managing melasma. Nevertheless, it's important to be aware of potential side effects such as temporary redness, flaking, and dryness. 

Intravenous glutathione has garnered attention for its skin-whitening properties, but it's essential to exercise caution. This treatment is not FDA-approved and may carry potential side effects, particularly for individuals with darker complexions. 

Given your brown skin and the risk of post-inflammatory hyperpigmentation, it's crucial to approach treatments with caution. I strongly advise consulting a dermatologist who can thoroughly assess your skin and recommend the most appropriate and safe treatment tailored to your specific needs.



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