<human>: sir, i have black shade on my both cheeks many medicine used but no change iam 52 aged person ,one of my friend advice me to use metasone plus cream & fluticasone oinment b.p. both mixe and apply . iam expecting your valuable advice . thank you doctor.
<bot>: Hello and welcome to Chat Doctor Hyperpigmentation of face, commonly known as plasma, is managed on 3 basic principle steps:-Inhibition of cladogenesis to prevent synthesis of new pigment and thus relapse.-Exfoliation to shed away the existing pigment and-Sun protection to prevent further sun induced darkening I was the treating doctor I would suggest you to use a broad spectrum sunscreen throughout the day, that which offers both UV A and UV B protection. Reapply the sunscreen every 2-3 hours, in adequate quantity. At night, you could use a cream containing one or more of the skin lightening agents like comic acid, HY Chat Doctor.  These ingredients inhibit synthesis of new pigment by inhibiting cladogenesis. Simultaneously you could also opt to undergo a little glycolic acid peeling sessions from a dermatologist, to exfoliate existing pigment. Metasone plus cream is a triple 