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Dermatology (Expert Forum)
Hypopigmentation
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
Hypopigmentation
by marlanage49, Feb 10, 2008 01:39PM
Hi Dr. Rockoff,
A little history:
27 y/o AA male, with no significant PMH, who essentially has had oily skin, and excessive sweating problems for as long as I can remember (teens). Approximatley 8 years ago, I began noticing hypopigmented lesions on my upper arms and torso, but was not too concerned about them at that time. Of note, my skin would occasionally be itchy after sweating. I concurrently began developing excess hair growth on my torso, back, upper arms, buttocks, and lower back, which has progressively worsen througout the years.
Saw a PCP about 7 years ago who diagnosed me with tinea versicolor (did KOH test). He assured me that it was purely cosmetic and that my body hair will essentially "cover it up".
SInce then, the hypopigmented leisons worsened, involving my whole anterior torso, chest, back, upper arms and neckline, and parts of my lower back. I have seen three dermatologists.
Prescribed : Nizoral (2 seperate times, PO), Diflucan, (Selseb Shampoo), Protopic ointment, Benzoyl peroxide wash, and intermittent PUVA treatments (essentially tanning booths at $100 for 10 minute sessions x 4 with Oxsoralen therapy).
I can tell you that the itching has stopped. and any scaling that was present before is gone. The issue I have is the residual hypopigmentation that has remained. I tried to self tan (as recommend from some online sites), but that has not seemed to work. I now bathe daily with a ZNP bar (Pyrithione Zinc 2%) to help reduce relapses.
My questions is: What can I do to repigment my skin. I have read the literature that says it may take 6-12 months - but this has essentially been almost 2 years without resolution. Again, this being cosmetic, it poses more of a a psychological/emotional issue than anything else (not to mention the concomittant hirsutism), and definitely compromises my quality of life (self-consciousness, intimate relationships, confidence). Hesitant to wear open collared shirts.
Thanks!
A little history:
27 y/o AA male, with no significant PMH, who essentially has had oily skin, and excessive sweating problems for as long as I can remember (teens). Approximatley 8 years ago, I began noticing hypopigmented lesions on my upper arms and torso, but was not too concerned about them at that time. Of note, my skin would occasionally be itchy after sweating. I concurrently began developing excess hair growth on my torso, back, upper arms, buttocks, and lower back, which has progressively worsen througout the years.
Saw a PCP about 7 years ago who diagnosed me with tinea versicolor (did KOH test). He assured me that it was purely cosmetic and that my body hair will essentially "cover it up".
SInce then, the hypopigmented leisons worsened, involving my whole anterior torso, chest, back, upper arms and neckline, and parts of my lower back. I have seen three dermatologists.
Prescribed : Nizoral (2 seperate times, PO), Diflucan, (Selseb Shampoo), Protopic ointment, Benzoyl peroxide wash, and intermittent PUVA treatments (essentially tanning booths at $100 for 10 minute sessions x 4 with Oxsoralen therapy).
I can tell you that the itching has stopped. and any scaling that was present before is gone. The issue I have is the residual hypopigmentation that has remained. I tried to self tan (as recommend from some online sites), but that has not seemed to work. I now bathe daily with a ZNP bar (Pyrithione Zinc 2%) to help reduce relapses.
My questions is: What can I do to repigment my skin. I have read the literature that says it may take 6-12 months - but this has essentially been almost 2 years without resolution. Again, this being cosmetic, it poses more of a a psychological/emotional issue than anything else (not to mention the concomittant hirsutism), and definitely compromises my quality of life (self-consciousness, intimate relationships, confidence). Hesitant to wear open collared shirts.
Thanks!
Doctor's Answer
by Alan Rockoff, MD, Feb 10, 2008 04:52PM
, Feb 10, 2008 04:52PM
To: marlanage49
It certainly sounds as though you have tinea versicolor. Although I have seen it take an awfully long time--years--for the color to even out, I have never seen it stay discolored forever, nor have I heard of that happening. I think you have killed the fungus quite dead, and I really think there's not much else for you to do but wait. Your patience will be rewarded, and besides, there's no other treatment to offer.
Take care.
Dr. Rockoff
Take care.
Dr. Rockoff
