Q: My wife is 40 years old and has dark patches under her eyes for the last 2-3 years. Earlier her face was quite clean & smooth. She consulted various skin specialists but without improvement. She gets itching on the affected area. She avoids going out in the sun, as she gets itching and slight swelling. Doctors prescribed Lorivol, Mellalite cream, Enurosonic cream, Suncream - photoban-15 lotion but no medicine worked. She got more swelling, redness and itching after using these medicines. She stopped using them finally. How can this problem be cured?

A:Since the pigmentation is associated with itching, redness and some amount of swelling, it seems the patient has some primary inflammatory process and that pigmentation is a secondary problem. There may also be an element of photomelanosis. Causes of this kind of inflammation are many; e.g. contact dermatitis and collagen disorder. Unless the nature of the basic primary problem is understood and eliminated, medication will have to continue to maintain improvement. She seems to have developed sensitivity to some of the medicines given to her; since redness and swelling increased after medication. Therefore, medicines to be selected henceforth should not have cross sensitivity with those aggravating the problem.