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    melasma/ broken blood vessels
    jenleebrod posted:
    Dr. Evans- after my honeymoon in Cancun, I came home with what looked like clusters of freckles or like my face was dirty in places. I had it on my forehead, along that bone under my eyes and above my top lip. I saw a dermatologist and they told me I had melasma. They prescribed hydroquinone, which I used daily for about 10 months. I did see some lightening. I am not pregnant nor was I when I discovered the melasma; I have been on the birth control pill for 16 years. This past January I started skin treatments; I did 7 photofacials and 5 microdermabrasion between January and June. They were spaced 2 weeks apart for each treatment. I also have several areas around my nose and checks where I have some broken blood vessels. Now that the treatment is over, I do see results; however, neither the melasma nor the blood vessels are entirely gone. I am now very diligent about wearing sunscreen on my face every day no matter what the weather and in the winter as well (I live in MN). I wear hats too and spend very little time in the sun especially in peak hours. I am wondering what else I should do to prevent the melasma from getting worse and/or the blood vessels from returning or continuing to multiply. Would more skin treatments ever remove the melasma or blood vessels completely? The treatments were $$$ and I don't think I can be doing that again anytime soon. I am 35 years old with pale skin and have never been a sun worshiper; although, when I was a child I was outside a lot and had a golden tan. I've never used a tanning bed. I feel too young to have these skin problems and don't want them to get worse. Thanks for your advice.
    Susan Evans, MD responded:
    Dear Jenleebrod,

    Thank you for your post. It really sounds like you have quite a complex history of skin care regimens. One thing that stands out is the frequency of your treatments.

    Over the years,I have had a few patients that were applying their topical treatments too frequently and simply did not allow their skin adequate time to recover between treatments. You should carefully review the recommended treatment protocol with your physician.

    Hydroquinine works great for the majority of patients, but for some patients, I've had to explore other options for skin brightening . You may want to consider alternative brightening agents. Look for products that contain niacin and licorice extract along with a gentle exfoliator included such as AHA or Papaya base products.

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