I am a 31 year old female and have melasma. How does one treat this skin condition?

Melasma results in darkening of skin and thus all treatments are geared towards lightening your skin. Current treatments for melasma include sunscreens, bleaching creams (e.g. hydroquinone), acne creams (e.g. azelaic acid), topical retinoids (e.g. tretinoin), and facial peels where an acid solution is used to remove outer layers of skin (e.g. glycolic acid peels or the blue peels). 

Some spas also incorporate a combination approach such as triple-combination cream (hydroquinone, tretinoin, and steroid). Some plastic surgeons also offer a variety of lasers to get rid of your melasma. As to which one is the best is anyone’s guess. 

What you have to understand that in most cases, melasma disappears on its own. So it is impossible to tell if anyone of these remedies really work!  The only two things for sure are that 1) you will certainly be paying big bucks for anyone of these treatments and 2) one of these treatments will probably worsen your skin condition 

Can you please tell me what is melasma? I am a 26 year old female who is 14 weeks pregnant.

Melasma is a skin disorder and is also known as ‘chloasma’ or ‘mask of pregnancy’. Melasma is associated with dark patches of skin which gradually develop on cheeks, forehead, nose, and upper lip. Melasma is more common in women and is associated with pregnancy and certain medications that contain hormones. Melasma seems to develop in about 60% of pregnant women but can also occur in men. Melasma is most common in Asians and in those with dark skin complexion.

Even though many women develop an enormous amount of mental anguish over this skin disorder, melasma is completely harmless. The majority of cases of melasma spontaneously disappear- this means that you do not have to go to unscrupulous doctors who now offer treatments for a condition which resolves on its own.

I have some tiny spots on the upper eyelid. My doctor says they are milk spots or milia. He recommends removal. What do you think?

I think your doctor is not interested in your welfare. Milk spots or milia are tiny lesions usually seen around the eyelid or nose. They are most common in newborn babies and are often mistaken for other skin lesions like warts or acne. The majority of milia spontaneously resolve on their own. Milia are not life threatening and the only reason to remove them is cosmesis. If they do not bother you, leave them alone. Best advice, stop mucking around with benign skin lesions around there eye. Many an individual has developed serious damage to the eyelid and eye from bad doctors.

Besides a moisturizer what else can l do to treat my dry skin?

Besides the face, hands suffer from dryness. Thus, avoid contact with water while washing dishes and wear gloves. If your hands are constantly cold and wet, apply a moisturizer and wear warm gloves. When you come home from the cold, change your socks/gloves since cold garments can worsen the itching and cracking of skin.

At home, you must use a humidifier to moisten the air. Humidification will ease your breathing and help you sleep comfortably. Finally drink lots of water. Drinking ample water keeps the skin hydrated and prevents itching and wrinkling of skin. If your skin is peeling and dry, keep away from all alcohol based skin care products and peeling agents. These substances will only worsen your skin.

While it is fun to soak in a hot tub at the end of long day, limit exposure to hot water in the winter. Too much hot water can lead to itching and dryness of skin.

Why is my skin dry in the winter?

Many people forget that during winter the skin requires little bit more care. The cold weather and wind often causes severe dryness of the face, hands and feet. This dryness often causes skin to crack, flake, peel and itch. Moreover, this problem is worsened by indoor heating. Skin dryness is a major problem during winter but there are many ways to prevent the damage. First and foremost you do not need to see a doctor. Common sense home remedies can help you prevent and treat dry skin. The treatment of dry skin begins with the use of a moisturizer. There are hundreds of moisturizers on the market. For winter skincare, go with oil based moisturizers. Baby oil is as good as any product. Remember the more fancy moisturizers which smell great also have many synthetic chemicals and thus the chances of contact dermatitis are increased. If you prefer, buy moisturizers which contain glycerin and alpha hydroxyl acids. These moisturizers must be used liberally everyday.

How can I remove my skin tags?

Skin tags are simplest lesions to remove. Because these skin lesions are attached by a small stalk, they can be easily sniped off. Other methods of removing them include freezing, laser or heat (electrodessication). Plastic surgeons always recommend the laser because it costs the most.

Because skin tags are no big deal, many types of doctors remove them. However, skin tags located near the eyelids should be removed by a plastic surgeon or an eye doctor. This part of the body is very delicate and the regular doctor can easily mess up your eye and eyelid. 

No matter who removes your skin tags, make sure they do give you numbing medication because these darn things hurt as hell during removal (personal experience)

I have been told that I have skin tags on my neck and upper eyelid. Do I need to get them removed?

Of course not. The more you go around looking for trouble from surgeons, the greater is the chance you will find it. Skin tags are very common growths that commonly occur in areas of the body where there is friction. Skin tags usually measure a few mm, are painless and may be multiple. Skin tags tend to occur under the armpit, neck, groin areas and inner thigh. There is no fancy test required to make a diagnosis of skin tags. 

An astute physician can easily make a diagnosis by looking at them. Skin tags may increase in number with age but rarely disappear on their own. Skin tags may get pinched, squeezed or scraped. Occasionally they may bleed. However in most cases skin tags are only of cosmetic nuisance. If you do not mind your skin tag, you really do not require any treatment.