Avoiding uneven pigment problems this summer

Hi! I used a tiny bit of a cream hydroquinone but, since it was a new product and I’ve never seen hydroquinone before, I didn’t noticed it was oxidized (it was brown but I thought it was its normal color. The thing is that it burned my skin, now is irritated and brownish. I just used it just once. Are this dangerous? Will my skin be permanently brownish spotted? Will it give me “confetti spots? Will it kill my melanocytes? I’m scared and sad. I feel stupid. Thank you in advance, Dr. I

Ouch….that sounds very uncomfortable!  I’m so curious…  did you buy that from the web?  I’m asking because the prescription forms available through the drugstore really shouldn’t be oxidized.

Whether the injury is an acne spot, bug bite, skin product irritation, or scratch, superficial skin injuries heal quickly.  But unfortunately they often result in a temporary (1-12 months) brown spot.  This is called PIH (post-inflammatory hyperpigmentation).  This is different than melasma, which is usually related to UV light and female hormones, especially pregnancy. If you don’t know what is causing your pigment problem, please see your dermatologist.

Remember the darker your skin type, the more likely you are to form temporary uneven pigment after a skin injury.

Skin cancers can sometimes look like brown spots. See a doctor, and don’t take a chance!

A brown spot due to skin injury

  • So no, this is usually not permanent.  But “temporary” might even last up to 12 months in rare cases.  1-3 months is more common.
  • The hydroquinone (HQ) won’t kill melanocytes, it just inhibits pigment formation.  I’m assuming the usual concentrations available in the U.S.
  • When you get a skin injury, use a zinc oxide 20% sunscreen several times a day to protect it from UV while you are healing.
  • Irritation may occur from any HQ product and make the pigment worse! Not improving?  Or getting worse on the HQ, please stop and consult your doctor.
  • “Triple cream” forms like Triluma are often better tolerated. Even though more expensive, they may be worth it.

Once you have it, how to get rid of it

  • If you’ve tried for several months, and it’s not better, please see your doctor.
  • Brown spot lightening often works ….usually apply all over lightly so you don’t get a “halo” around the brown spot or be careful.
  • Those include HQ and Triple Creams (prescription only), and plant based lighteners which are more effective now.  Try the MadisonMD Lightening product or Skinceuticals Discoloration Defense.
  • Use a brimmed hat if on the face, and double sunscreen with high zinc sunscreens (15-20%).
  • Don’t use peels unless you can stay out of the sun for at least a month afterwards.  And please go to someone who’s very experienced with these.  They can make you worse.
  • Avoid lasers in the summer, or if you are outside a lot.  Discuss with your dermatologist first.
  • Expect very gradual improvement.  It’s not as fast as we all would like.

I hope this helps,

Dr. Brandith

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