### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Sir, I have the following skin problems, a. brown patches on forehead b. skin turned brown and thicker than than the rest on finger joints c. face atleast 5 shades darker than body I spent a lot on cosmetic stuffs like Kaya skin clinic etc with no appreciable improvement. My job requires frequent abroad travel and can t religiously follow the so called skin care regime (cleansing , sun cream etc) I had a history of gastric problems and recently consulted a renowned doctor. According to the blood report I have low Vitamine B12 (around 248) .. which is apparently the root cause of of stomach problems as well as hyper pigmentation. However, for the skin related issue I d rather get the final verdict from a Dermatologist and hence the questions - a. Does my skin condition have anything to do with Vitamine B12 deficiency ? b. How do I go about solving for the pigmentation problem (by now I m convinced that this is not about the skin surface .. have done many facials / hydroquinone creams / glycolic pills) If you could please set a direction through a response to the above

### output:

Hello welcome to Chat Doctor forum thank you for your query yes, there is relation between vitamin B 12 and skin problem .low b12 cause hyperpigmentation and skin thickening, but there are other reason for this like heredity, smoking, sun exposure, acanthuses Nigerians etc .you can get b12 injection for 5 times to restore it.sunscreen and good moisturizer are corner stone for treatment serum insulin level will also advise ruling out it resistance .so the best thing is consulted dermatologist and make treatment plan and follow it I hope I answered your question