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dermatology questions submitted to dermatologist Question of the Week
 
@dermatologistuk. I have pigmentation on my face.
I want to know if treatment is available for clearer skin - to remove the pigmentation? -
via twitter
 
Dr Ashworth Says: There are many causes of facial pigmentation and the true answer to the question depends upon the causation - in practical terms I think my answer should be - "reducing facial pigmentation is extremely difficult and sometimes impossible - many patients have facial pigmentation indefinitely into the future".
 
Having said that, there are a variety of treatments which are certainly worth a try - they all depend upon one very important factor - the patient must be prepared to absolutely and totally, completely, avoid sun exposure on the face, Winter, Spring, Summer and Autumn - ie all year round for at least 2 or 3 years. By keeping out of sun whenever possible and wearing a full factor total sun block at all times irrespective of the weather. This is in addition to extra treatments.
 
Previous Questions:
 
"@dermatologistuk husband just starting Aldara 5 0/0 any advice?" - via Twitter
Dr Ashworth Says Aldara (imiquimod) is a cream which comes in small sachets. It was licensed initially for treating genital warts but was then found to have benefits in other skin disorders.
It stimulates the immune system into "attack" mode which makes the body attempt to destroy the abnormality in the area.
It is usually prescribed for 5 days per week (2 days off) and repeat for 6 weeks.
It can cause very intense soreness and inflamation in some people - the 2 day holiday each week might need to be extended in these sensitive patients.
After 6 weeks, stop and let the whole area settle down (maybe apply simple Savlon) and let your doctor reassess the area about 2 weeks later A single sachet is sometimes enough to last a full week depending on size of treatment area.
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