Skin Republic

CEBU, Philippines - Whenever I see my patients, I always try to answer all their questions as best I can. After all, a better understanding of our skin is the best protection. Which is why when I received some inquiries and very practical concerns from some readers, I decided to address them as best as I could.

Dear Skin Republic,

I have big dark spots on each side of my cheek that appeared a couple of years ago. I have tried several bleaching creams but it just seems to be getting darker. What causes this and what can I do to treat it?

Brown spots at 50

Dear Brown Spots,

Melasma, as the brown spots on your cheek are called, are the bane of existence of many Filipino women. A combination of sun exposure, change in hormones or the use of irritating cosmetics are the culprits. Women on pills, contraceptive injections or pregnant women are more likely to get melasma. Asian women in general have a higher incidence of melasma.

There are several ways to go about treating it. Start with proper assessment: a visit to your dermatologist (PDS-certified) can give you an initial evaluation to see if it is indeed the treatable kind. Your dermatologist can gauge if it is the superficial type (only epidermal involvement) of melasma compared to the deeper dermal type. Treatment options include chemical peels, bleaching creams, sunblock or lasers. I've found that a combination of all the above comes up with the fastest result.Over-the-counter bleaching creams are either not strong enough or may even worsen your melasma. As for the laser treatment, make sure your dermatologist does a test spot first before doing the entire affected area. Each of us responds differently to lasers. Hence, doing a test spot is the safest way to ensure the right setting has been chosen and to avoid dark scars.

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Dear Skin Republic,

I read your column and became convinced to seek treatment for my 19-year-old son's pimples. He's had it for more than four years. I cannot afford treatments offered in spas for him. Is there any other inexpensive way to treat it?

Concerned Father

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How wonderful that you are concerned over your son's pimples. Getting rid of acne can significantly boost one's self-image. Unfair as it may seem, pimples can sometimes get in the way of getting the right girl or even the right job! Acne has multiple causes: genetics, hormones, stress, environment, cosmetics, and even food, though to a lesser degree.

To start with, all irritating facial soaps and toners must be stopped. Many of the scented soaps and facial creams might be too harsh for your son's skin. Then get an initial check up with a dermatologist (again, PDS-certified), as it is important to assess whether the acne is mild, moderate or severe; and what kind of individual lesions are seen (cystic, pustular, comedonal, etc). The treatment regimen will then depend on these findings and your son's skin type. You can tell your dermatologist to stick to your budgetary needs and he/she will prescribe accordingly.

Pimple treatments can be varied and need not be expensive. Available options like accutane, blue light laser and photodynamic therapy may sound appealing, but are costly. More affordable and just as effective are topical antibiotics (Clindamycin or Erythromycin) and varying brands of tretinoin that are widely available locally. These still provide excellent results. Some dermatologists may opt to add or even use as main treatment formulations, like glycolic acid, salicylic acid, mandelic acid and benzoyl peroxide, but all depending on the severity and type of acne. I'm sure you can find the right dermatologist who can direct you to a proper and economical treatment for your son.