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

### input:
Hi I am 35 married female suffering from hyperpigmentation on cheeks and uneven spots all over face . Have tried every treatement except laser and the problem doesnt go. I am not on contraceptives either. Please help You answer doesnt help since diagnosis might be wrong. Please note I dont have a baby yet nor I am on contraceptive... nope nothing wrong with me in this area, its just that I just got married

### output:

Hi!, Welcome to Chat Doctor forum, According to your history, it seems that you have PLASMA, since you quoted that you are not on oral contraceptive pills, and you have not had any issues either. These questions you would have faced by many doctors. It is true that such pigmentation is often seen after pregnancy or one who is on OCS. But we have been seeing such pigmentation on those who have not had such a history either. So, even if you never had a baby, one can have such pigmentation problem, just because of slight shift in the hormones in the body. It is the estrogen level in the blood which is more responsible for such pigmentation. If this is plasma, we are dealing with a very chronic problem. It can wax and vain also. Sunlight & stress also has a big role to play. The best advise here would be to use a triple combination cream to begin with, and then gradually taper it off.Don't use it for more than 2 weeks. As you taper it gradually starts using HY Chat Doctor. Along with this also start using comic acid & it c based creams in day and evening. But please don't forget to use a good SPF sunscreen daily thrice. Sunscreen is mandatory. You can even undergo chemical peeling from an experienced dermatologist. Results of this all might vary from patient to patient. Now being a laser expert I've myself done the number of cases with lasers too. The best of the laser for this is Q-switched Nd:YAG laser. But one cannot guarantee you any great results with this either. The results are variable here too. And its costly also. Plasma has always been a very frustrating problem both for the patient and the treating doctor. It is one thing which can destroy the reputation of most reputed doctor. So, have patience and kindly consult a dermatologist for this. Please do not take any beauty parlor treatment for this. This is one possibility what came in my mind. Secondly it might be freckles too since you said you have spots all over your face. Lasers is best for treating freckles. You may require only one sitting for this. Kindly consult an experienced dermatologist who can diagnose and treat your problem. I hope this answers your query, if you any further questions, kindly write back to us. Regards,