Melasma

Q.I am 39 years old and have had small, embarrassing dark spots on my face for approximately 10+ years. I was told that they are probably the result of using birth control pills. Anyway, I have tried OTC products containing Hydroquinone, however, after using them for 3+ months, and not seeing any improvement what so ever, I gave up. I recently found and ad for a product called "Actifade," which guarantees that it will omit dark spots within 3 - 4 weeks, however, the cost is $100 for a two month supply - way more than I am willing or wanting to spend. Can you please recommend a product(s) that would give me speedy results at a lower price? I would be more than thankful as I am so tired of using concealers to hide these spots on a daily basis. Thanks for your time.

A.What you are describing sounds like melasma. This is a condition where women get dark areas on the face from estrogen hormones AND sun exposure. The estrogens are from pregnancy, birth control pills or even normal internal production of estrogen. Melasma usually consists of large dark "spots" on the face and not small dark spots. Treatments vary and include bleaching agents (hydroquinones), acids (glycolic, salicylic and lactic) and retinoids. Effective improvement usually employs combinations of the above. Treatments is usually ineffective if you don't use sunscreen, SPF 15 or above, twice a day.

As you can see, cost varies. You should be able to get a comprehensive program for well under $100.