Brown spots on face

[Guest Posts]

Guest post on behalf of OR Sussex

'Can you help?

I am in my thirties and have recently noticed brown patches on my forehead which are getting darker. I am pregnant with my first child at the moment and wondered if it was my hormones? If so, will these patches go away or can I get rid of them as they are making me feel self conscious.

Thanks in advance'

[Dr Anjali Mahto]

Many thanks for taking the time to post a question. Pregnancy and its hormonal fluctuations can commonly cause problems with skin pigmentation - usually a condition called melasma. It occurs due to over production of the pigment cells or melanocytes and can often be a chronic condition i.e. it can be controlled but not necessarily cured.

There are very few treatments safe during pregnancy but the most important thing you can do is start wearing regular high factor SPF 50 which offers protection against UVA, UVB, and high energy visible light. This should be worn throughout the year as sunlight can be one of the driving factors in this condition.

After pregnancy, there are a number of methods that can be used for treatment and a good cosmetic dermatologist will be able to explain and have access to all the possible treatments and discuss pros and cons with you (try www.bcdg.info). Treatments include the following:
1. Bleaching or brightening creams - these contain a variety of different ingredients including tretinoin, hydroquinone 2-4%, kojic acid, arbutinin, azelaic acid, vitamin C to name a few
2. Chemical peels - these often need to be repeated and various peels exist to tackle pigmentation
3. Laser treatments are available and can produce variable results. These should be used with caution and much depends on the experience of the practitioner as treatment could potentially make melasma worse.

Often a combination of these treatments may provide the best result. There are also agents under investigation or with emerging evidence behind them such as tranexamic acid which may be used either via injections or as an oral medication.

Lastly, also I would mention that it may be worthwhile looking at good quality camouflage make up which can hide the areas. If your melasma is affecting your day to day activities or affecting your self-esteem then please seek medical help.

I hope this answers your questions and best of luck.

Anjali

[Dr Nisith Sheth]

A very full and informative answer from Dr Mahto. I fully agree with her. Sunscreen is essential. The other treatments can be very effective depending on the exact nature of pigmentation but are best done after pregnancy