Q: I am 26 years old and have a skin pigmentation problem. The skin around my mouth is slightly dark and hence gives an unpleasant look to my face. I have shown myself to various doctors and they all suggested different creams to apply. However, my problem is not yet resolved. I have this problem since 4-5 years now. The skin becomes more dark and prominent especially when I get to sleep less. The external creams that I have used so far are Ban a Tan, Melacare and now using Demelan and additionally I have been advised to take Vitamin Tablets. It all started when once I mistakenly applied a hair removal cream on my upper lip to remove hair. I have now given up and want one last solution to this so that this is permanently cured. I am very confused. Please help me out. This problem is causing me embarrassment.

A:Perioral pigmentation could be due to hair removal creams, cosmetic creams (especially anti-wrinkle) or even fluorinated toothpaste. To find out a cause, a detailed work up is required. If you are using them avoid them and apply Aziderm cream (20%) cream in the morning and Demelan cream at night. Take Cap. Evion 400 mg daily. Generally, if you avoid precipitating factors, your problem can be solved.