hyper-pigmentation

Hello.  I have hyper-pigmentation above my upper lip. It's not nearly as bad as the pics I see online, so I am a mild case. I was taking birth control pills for almost 10 years (I am 34). I stopped taking them about 3 months ago when I was informed that this could be the cause. I used hydroquinone 4% precribed by a derm for 1 year & didn't see any good results. I then was using a cream that a derm made himself with no results. I also tried a gel that I purchased online. So now I'm using hydroquinone 8% for about 2 months. I do use the special sunscreen with oxide every day & I wear a hat on the beach. It is horrible trying to stay covered when on a wonderful vacation and its almost impossible to cover from the sun's affects, even with a hat & umbrella. I would like a treatment that actually works and will get rid of this. I am concerned that it will get even worse when I get pregnant (within 1-2 years), but it would help to know that there is a treatment that actually works??? Also, any suggestions on covering it? I currently use Dermablend concealer, but doesn't do that much.  
Thanks for your time.

[Alan Rockoff, MD]

This is hard to treat, but the best treatment available is TriLuma, which is available by prescription.  It's important as well to use a sunscreen that provides but UVA and UVB protection, though no block will block all rays, and any rays that get through will darken the lip.  I know that this condition is often blamed on hormones, but there is often no correlation either way (that is, stopping the pill may not make you better, nor will getting pregnant make you worse.)  I suggest you stop the 8% hydroquinone, which is too strong.

Best.

Dr. Rockoff

[suzy032]

A related discussion, Pityriasis Versicolor was started.