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I have advised you to use Pigmanorm Cream on a regular basis to try and improve the overall quality of your skin, especially the pigmentation which concerns you.
The important thing to remember is Pigmanorm Cream may be an irritant and, therefore, your skin may become inflamed and peel if you use the preparation too liberally. Your skin will, however, build up a tolerance to it with time. It is, therefore, appropriate to start to use the product intermittently and this could either be for three or four hours a day or just over night twice a week. This depends on which regime is easier for you.
If you use the Cream intermittently for approximately two weeks you can then start to use the preparation over night every other night and, assuming you get no untoward reactions in terms of redness or dramatic peeling, you can start to use it over night every night after another two weeks. This regime usually allows you to build up tolerance to the Pigmanorm without too much local irritation. You should not apply the product to any treated areas of skin until they have healed completely. If you develop any reaction, stop using the Pigmanorm and continue your normal skin care routine. The reaction will settle over a few days and you can then re-start more cautiously.
As Pigmanorm may make your skin slightly more sensitive you should be cautious about using other preparations containing Vitamin A. You will also need to be obsessional about sun protection, sun avoidance and the use of high factor sunscreens protecting against both UVA and UVB. If you are travelling to any hot countries, I would suggest you stop using Pigmanorm 7-10 days before your departure. Resume use cautiously on your return.
You should not use Pigmanorm for more than 8 weeks without discussing it with me. It contains a strong anti inflammatory steroid cream which can thin the skin if overused.
If you have any queries or concerns, please do not hesitate to contact the office.