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15 Oct 2008

bruin vlekke op wange
goeie dag ek wonder of u my kan help ek het bruin vlekke op my wange ek het dit gekry net nadat ek swanger geraak het met my kinders is daar iets wat ek kan gebruik om dit weg te vat of dan ligter te maak. dankie
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Expert
Anti-ageing expert
Anti-ageing expert

01 Jan 0001

Hi Ronell, thank you for the question and my apologies for the delay with your answer but I have just returned from my London clinic.

Your best option is to consult a dermatologist or an aesthetic medical practitioner who can examine the area of concern and give you the appropriate diagnosis and treatment regime.

The brown marks you have noticed is most probably a form of pigmentation that is known as Melasma.
Pigmentation is an over production of melanin (pigment) in the skin and may result directly from the sun or indirectly following trauma to an area or as a response to hormonal changes (this includes taking the oral contraceptive and pregnancy). To treat the pigmentation we need to establish what the cause of the pigmentation is as this will determine the treatment choice.
No matter what the cause of the pigmentation is always remember to avoid the sun as much as possible (use a hat) and always use an oil free SPF 30 or higher that contains zinc oxide and/or titanium dioxide (my personal preference is Heliocare SPF 50).

If the pigmentation has been caused by SUN DAMAGE only, you have several choices for treating the areas of concern:
Glycolic acid peels and mandelic acid peels (these 2 may be used in combination).
Topical creams – should contain glycolic acid, mandelic acid, vitamin A, vitamin C, kajoic acid, mulberry root extracts, and one may even consider adding hydroquinone (2% or 4%). This is a long term option and you will only start to see some improvement within 2 to 3 months of consistent use.
The NeoStrata range contain all of the ingredients listed above but one may find them in combination in one form or another with Environ, Nimue, etc.:
NeoStrata Complexion Gel
NeoStrata Brightening Cream
Skin rejuvenation – laser or IPL based machines specific for pigment removal can be used. The pigment removal is usually faster than creams and in some cases, only 1 session is required.

HORMONAL CHANGES that produce pigmentation is known as Melasma or Chloasma, and typically forms on the cheeks, upper lip, forehead, and less so, on other parts of the body. If the pigmentation you see is Melasma the treatment becomes more difficult, as one needs to differentiate if the pigmentation is dermal or epidermal.

If the Melasma is dermal, laser or IPL will actually DARKEN and worsen the appearance of the spots.
DERMAL MEALSMA is generally unresponsive to most treatments, and has only been found to lighten with products containing mandelic acid. So your best approach would be to use a combination of glycolic and mandelic acid peels together with topical products containing mandelic acid.

If the MELASMA IS EPIDERMAL one may try the topical treatments listed above together with the following:
Hydroquinone: prescription (4%) strength.
Tretinoin, an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy.
Azelaic acid (20%), thought to decrease the activity of melanocytes.
Facial peels with alpha hydroxy acids (mandelic) and/or glycolic acid.

So in summary, your best approach is to have the pigmentation examined, and from there to decide the treatment regime. However, there is nothing stopping you from trying the topical approach first.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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