Hyperpigmentation or Melasma on the bridge of nose

Question #22043

33 days ago

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Hyperpigmentation or Melasma on the bridge of nose - #22043

Arya S Nair

I am 26 F from India with dark skin or brown skin. Since the age of 12 I have add skin issues like hyperpigmentation.At 12 I have this skin peels in the corner of my nose and the skin was thick also very dark. That hot better and after few yearsthe top of my nose became dark in a symmetrical manner on the nose bridge leading to the corner of my nose and also in the fold of my chin. I also have some uneven skin tone on my cheeks but very obvious, the pigmentation feels like it’s under the top layer of my skin. Now I’m 26 still could get the pigmentation off my nose bridge. Please help. It gets worse with sun exposure. I have oily skin on my t zone and dry everywhere else. My skin is sensitive also. I get acnea too. No dermatologist could help me figure this out. Please help.

Age: 26

Skin pigmentation

300 INR (~3.53 USD)

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

31 days ago

Based on your description, you may be experiencing a common skin condition known as melasma or possibly a form of post-inflammatory hyperpigmentation. Both can result in dark patches on the skin, often worsened by sun exposure, and commonly seen on areas like the nose bridge and cheeks. Since your skin is sensitive and sun exposure worsens the condition, it’s important to incorporate sun protection and a skin-care routine tailored to your skin type. First, work on sun protection religiously; use a broad-spectrum sunscreen with at least SPF 30 and factors like PA++. Apply generously to all exposed skin, even on cloudy days, and reapply every two hours if you’re spending time outdoors. Consider wearing a wide-brimmed hat or seeking shade when possible. Sunscreen alone may not be enough, so you might benefit from topical treatments, such as hydroquinone, azelaic acid, or even glycolic acid, which can help reduce hyperpigmentation. These should be used cautiously and ideally under a dermatologist’s guidance, considering your sensitive skin. It’s also best to start with products with lower concentrations to avoid irritation. As you’re dealing with oily skin and acne, ensure your routine is non-comedogenic to prevent further breakouts. Regarding the use of products such as retinoids or exfoliants, they should be introduced gradually and with care, perhaps a few times a week, adjusting based on how your skin tolerates them. Another option to discuss with a dermatologist might be chemical peels or laser treatments, which can penetrate deeper layers of the skin but should be chosen carefully to avoid worsening pigmentation. Regular follow-ups with a dermatologist experienced in treating skin of color can be particularly beneficial to tailor treatments to your specific needs and monitor your response. Additionally, maintaining a healthy diet and managing stress can support overall skin health. If current recommendations have been ineffective, seeking a second opinion or consulting a dermatologist with specialized expertise in pigmentation disorders might provide further insights.

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

30 days ago

Hello Arya, thanks for explaining this. Your features strongly point toward melasma with mixed hyperpigmentation, plus a component of frictional / post-inflammatory pigmentation. This is not dirt, not poor hygiene, not a superficial problem, and not something that peels off easily.
This condition is controllable, not “curable”. Goal = lighten + prevent worsening. Progress is slow. Here is my advise-
1. Sunscreen - Beauty of Joseon Relief Sun Rice Probiotics SPF 50+ OR Cetaphil Sun SPF 50+ Light Gel. Apply every morning. Reapply every 3 hours if outdoors. Nose bridge needs extra amount. Without this, no treatment will work.
2. Pigment Control -
-Cream/Gel Azelaic Acid 10%: Night only. Pea-sized amount for entire face. Start alternate nights × 2 weeks, then nightly × next 2 weeks.
- Serum/Gel Niacinamide 4-5%. Either Morning or night. Apply before sunscreen in AM or before azelaic at night. × 4 weeks.
3. Acne + Oily T-zone care- Cetaphil Gentle Foaming Cleanser OR Neutrogena Ultra Gentle Foaming Cleanser. Use twice daily (morning and night). Apply on damp skin, massage gently, then rinse with lukewarm water. Follow with moisturizer and daily sunscreen. Avoid harsh scrubbing, gentle pressure only.
What you described on chin folds & nose corners, This could also include: Frictional melanosis, Seborrheic dermatitis history, Old post-inflammatory pigmentation. Which means: Be extra gentle, No rubbing, no scrubbing.
You’re not alone. This is common. Improvement is possible, but patience is key.
Review after 4 weeks.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, D.Fam.Medicine

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

27 days ago

Your long-standing, symmetrical darkening on the nose bridge and folds that worsens with sun exposure is most consistent with deep facial hyperpigmentation (melasma-variant or pigmented contact dermatitis), which is common and stubborn in brown, sensitive skin. Management focuses on strict sun protection (SPF 50+), gentle skincare, and low-irritation treatments like azelaic acid, as harsh products and steroid creams can worsen it. Specialist consultation: a dermatologist experienced in skin of color—an online consult can start treatment, but an in-person exam helps assess pigment depth and choose safe options.

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

32 days ago

Hello dear
See for melasma you can take below medication for improvement
Salicylic Acid, Adapalene 0.1% can also be given as additive medications.
2.Clindamycin 1%	Clindac A	,Tretinoin	( if already not taken).
3.Azelaic Acid	10 percent for two weeks.
4. Oral Medications -tablet Doxycycline 1 month twice a day  for max 5 days
Spf 30 topical application twice a day for 1 month
Tulsi alovera gel twice a day for 1 month
In case of no improvement following procedure may be required
Laser
Photodynamic therapy
Electrocautery
Prp or prf therapy
Botulinum toxin
Please get specialized procedure from dermatologist only
Regards

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

32 days ago

Your symptoms are most consistent with melasma with underlying chronic hyperpigmentation, worsened by sun exposure, hormonal influence, and sensitive skin. The symmetrical darkening over the nose bridge, corners of the nose, chin folds, and mild cheek involvement, along with pigmentation that feels deep under the skin, strongly suggests dermal or mixed-type melasma, rather than simple tanning or acne marks.
Because your pigmentation started early, worsens with sunlight, and has not responded to routine treatments, it is likely deep-seated, which explains why it has been very difficult to remove completely. Oily-sensitive skin and acne further limit aggressive treatments, making management more challenging but still possible.
Melasma is chronic but controllable, not dangerous, and improvement requires strict sun protection, gentle long-term treatment, and patience, rather than quick fixes. With the right approach, the pigmentation can fade significantly, though complete permanent removal may not be realistic.

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

32 days ago

Hello Arya
It sounds like you’ve been dealing with persistent skin issues for a long time, and I can understand how frustrating that must be. Here are some steps and suggestions that might help you manage hyperpigmentation and improve your skin condition:
1. Sun Protection:
- Sunscreen: Use a broad-spectrum sunscreen with at least SPF 30 daily, even on cloudy days. This is crucial as sun exposure can worsen pigmentation.
- Physical Barriers: Consider wearing a wide-brimmed hat and sunglasses when outdoors.
2. Gentle Skincare Routine:
- Cleansers: Use a gentle, non-comedogenic cleanser to avoid irritation.
- Moisturizers: Opt for lightweight, oil-free moisturizers for your T-zone and richer creams for drier areas.
- Exfoliation: Incorporate gentle exfoliation (like AHAs or BHAs) 1-2 times a week to help remove dead skin cells and improve texture. Be cautious with sensitive skin.
3. Targeted Treatments:
- Topical Agents: Look for products containing ingredients like:
- Vitamin C: Brightens skin and reduces pigmentation.
- Niacinamide: Helps with uneven skin tone and is gentle on sensitive skin.
- Azelaic Acid: Effective for both acne and pigmentation.
- Hydroquinone: A skin-lightening agent, but should be used under a dermatologist’s guidance due to potential side effects.
4. Professional Treatments:
- Chemical Peels: These can help improve skin texture and pigmentation. Consult a dermatologist for options suitable for your skin type.
- Laser Treatments: Certain lasers can target pigmentation effectively, but they should be done by experienced professionals.
5. Diet and Hydration:
- Stay hydrated and maintain a balanced diet rich in antioxidants (fruits, vegetables) to support skin health.
,6. Patience and Consistency:
- Skin treatments can take time to show results, so be patient and consistent with your routine.
Thank you and get well soon

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

32 days ago

Hello Arya,
Yes The pigmentation on your nose bridge is most likely melasma or deep hyperpigmentation.
It worsens with sun exposure and lies deeper under the skin, which is why it hasn’t cleared easily.
Daily SPF 50+ sunscreen (tinted is best)(Dot n key good option)
Azelaic acid 10–15% at night (safe for sensitive and acne-prone skin)
Niacinamide 4–5% in the morning
Gentle cleanser and light moisturizer(cetaphil/simple)
Avoid:
Scrubs, harsh peels, lemon or home remedies
Steroid or fairness creams
Over-exfoliation
Melasma cannot be removed completely, but it can fade significantly and be controlled with regular care and strict sun protection.
I trust this helps
Thank you

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Hyperpigmentation or Melasma on the bridge of nose - #22043

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