SkinRepublic

Dear Dr. Jen,

I am 53 years old and I noticed that I have plenty of small, white spots on my arms and legs.  What can you recommend to eliminate them?  I would rather use creams than undergo procedures because I cannot take a leave from my work.

Cecil

Dear Cecil,

Idiopathic guttatehypomelanosis, as those small white spots are called are often a part of the ageing process. It also runs in some families. If you take a look at the skin of your parents or your aunts, you usually find white spots in the older generation. In some cases, it is a sign of sun damage, like a white freckle.

These are harmless little spots but can be aesthetically displeasing.  Under the microscope, you see areas of the skin where there is a lack of melanin (pigment) and even scarcity of melanocytes (pigment-producing cells).

There are two kinds of lotions that you must incorporate in your beauty regimen if you want to get rid of these macules.  First, a nightly retinoid-based lotion will help diminish the appearance of whiteness.  Secondly, use of sunscreen lotion every morning to arms and legs can prevent new ones from coming out.  I hope this has enlightened you on your hypomelanosis.  Best of luck!

Dear Dr. Jen,

I always get pimples on my hairline and my eye brow area.  It hasn't responded to any anti-pimple medicines that my dermatologist has given me.  I am very frustrated.  Is there such a thing as resistant acne?

Janice

Dear Janice,

You may need to have your PDS derma take a closer look at those "pimples."   They might not actually be pimples but pityrosporum folliculitis.  Folliculitis caused by the specie malassezia or pityrosporum respond poorly to usual anti-acne medications. This must be why you are thinking the acne is resistant.  Plucking, waxing and threading can also aggravate the follicles, contributing to the lesions along the eyebrow. 

Sometimes, you may also need a thorough check up.  The problem might also be hormonal and your gynecologist may need to work hand-in-hand with your dermatologist.  Don't give up hope yet.  There are many other things that you can explore for your acne-like lesions.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan.