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Your problem seems to be a complicated and long lasting one. Why have you never consulted a doctor about this problem before? Fifteen years is a very long time, and it is possible that the problem could have been solved years ago when it was in its initial stages. The problem might now have turned into something chronic and more severe, so it might be difficult to address. Fortunately, you seem to have no other symptoms, so it is unlikely that there is anything seriously wrong with you, but it is always better to be sure. Problems like diabetes can cause what is known as insulin spillover, which causes hyperpigmentation of certain areas of skin, and this is certainly a problem that requires medical attention. You should therefore fix up an appointment with your doctor at the earliest. Some treatments for this kind of hyperpigmentation can in any case only be taken on prescription. If there is some underlying problem such as diabetes, then this underlying problem is of course what needs to be treated. Only when blood glucose levels are under control will the skin begin to show any improvement and the same goes for any other health condition that is causing the Hyperpigmented spots. However, if there is a problem with the skin itself, then you may need medication to directly target the production of the pigment melanin. Hydroquinone is most commonly used to lighten skin and works by affecting melanin production, but it should be used carefully as it can have harmful effects. Kojic acid is another drug that is used - it is produced by certain fungi, and has antibacterial and antifungal properties. In addition, it inhibits the production of melanin in the skin. There are several other options too, including tretinoin and alpha hydroxyl acids, but these are not effective in every case. Laser treatments are also used in the treatment for hyperpigmentation, but once again, the effects are not guaranteed, and the results can sometimes go to the other extreme - hypopigmentation, or the lack of pigment. Avoid using home remedies to get rid of this hyperpigmentation, unless the aim is skin care rather than lightening. Home remedies cannot do much against hyperpigmentation, and some might end up unnecessarily irritating skin and causing other problems. However, if the underlying cause is addressed and treated, proper skin care will speed up the recovery process. Proper diet, hygiene, and moisturization are therefore necessary.
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