In about three out of four patients it is superficial in the epidermis. In the remainder the pigment lies deep in the dermis or is a mixture of dermal and epidermal pigment. It is sometimes possible to distinguish the this pattern using special type of light called a Wood's lamp . If the pigment is in the epidermis it is often helped by bleaching agents such as hydroquinone. However, this is only effective if used for several weeks.
Some doctors feel that the hydroquinone is more effective when combined with retinoic acid .
Deep pigment in the dermis does not respond well to bleaching agents. Resurfacing procedures such as chemical peels and lasers may help some of these problems but the results are not always consistent. Request more information about cosmetic surgery home .