ASK A DERMATOLOGIST

I’m suffering from mildly purplish blue, ill-defined marks on my skin, mainly on my inner thighs and calves. This becomes more prominent in colder environments. I’ve been told it’s nothing significant. Can you kindly help?

Your description of skin rashes suggests you are most likely suffering from livedo reticularis – various skin conditions in which there is a mottled discolouration of skin. It is believed to result from disturbance of blood flow to the skin, causing low blood flow and reduced oxygen supply to the skin. We would not want to create any unnecessary fear or apprehension in you without going through a thorough medical exam and detailed laboratory investigations, which are absolutely necessary either to support or to negate the diagnostic suspicion. Therefore, our recommendation will be that you consult a highly experienced skilled dermatologist. Your observation of worsening or more visibility of your skin complaints in winter months seems quite valid, as in our professional practice too, most of the sufferers seen with livedo reticularis do exhibit similar phenomena in winter months with cold weather. The low temperatures in winter do contribute towards slowing of blood flow to the skin due to cold-induced vasoconstriction of the cutaneous blood vessels.

I’m a 33-year-old female and I developed dark patches on my forehead and cheek bones during my last pregnancy. Please help!

Although your question suggests you are suffering from two issues, both can be considered belonging to the family of skin pigmented disorders. Dark patches on your face and forehead are most likely melasma that affects about 20 per cent of pregnant women of Asian origin. Among other causative factors of melasma are genetic predisposition, hormonal disturbances, for example presence of polycystic ovaries, use of oral contraceptive pills and excessive exposure to sunlight. About 10 per cent of women sufferers develop thyroid gland disorder at some stage. The treatment choice is much dependent on the clinically determined Melasma grade. Grade one to two cases can be treated by use of topical skin lightening cream, gels or lotions. Whereas, grade three to four cases do require a more professional treatment approach, including use of various chemical peels alone or in combination with specific skin lightening lasers.

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