Considering treatment for melasma/hyperpigmentation

I am a 25 year old caucasian female.  About two years ago I noticed a light brown pigmentation of two areas of my upper lip.  The spots are relatively light, but still visible.  I believe these spots are melasmas.  I believe the melasma could be caused by my use of oral contraceptives for birth control (orthotricyclin-lo) for 5 years.  

I use SPF 70 UVA/UVB sunscreen on these areas every single day (SPF 25 on the rest of my face).  I have not tried any other treatment besides sunscreen.  I am considering using an over the counter product such as Ambi Fade Cream.  The product contains 2% hydroquinone.  I have read online that this ingredient was banned in Europe for being potentially carcinogenic.  I want to get rid of these spots SO badly (I'm tired of having to wear concealer all the time and still looking like I have a mustache), but I do not want to risk cancer.

What is your expert opinion of the safety of using 2% hydroquinone for a limited amount of time?  Should I try stopping my taking of birth control instead?  Your advice is much appreciated.  Thank you.


This discussion is related to Chloasma Questions.

[Bhupinder Kaur, MD]

Hello,
Hyperpigmentation changes due to melasma changes are caused by hormonal changes, which stimulate a temporary increase in your body's production of melanin. Women with darker complexions are more prone to this condition than women with lighter skin.

Treatment options include treatment with vitamin C and hydrocortisone, peel with carbon dioxide snow and alexandrite and ND-Yag Q-Switched laser treatment preceded by a hydroquinone-based application. Please discuss these options with your dermatologist. You should not use hydroquinone on your own without a dermatologist’s evaluation because it is not without side effects. I sincerely hope that helps. Take care.