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Steroid creams are prescribed by dermatologists for a range of skin conditions, and are often a first-line treatment for IGH. Your doctor will prescribe a specific topical steroid and explain how and how often to apply the cream to your IGH spots.  You'll usually apply the topical steroid once a day for at least 2 weeks, and probably longer before seeing results. Side effects from steroid creams are uncommon, but can include redness, thinning of the skin, or even permanent pigmentation changes. If you have IGH on your face or other areas where your skin is thinner, you'll need to use a lower concentration of topical steroid to reduce the risk of skin inflammation. If topical steroids cause unwanted side effects or you'd prefer to avoid them for other reasons, your doctor might recommend retinoids instead. The retinoid tretinoin is often prescribed for IGH as a topical cream because it is easy to apply and has mild side effects.  Retinoids are applied once daily, usually at night. It will take several weeks or possibly months to achieve noticeable results. If you experience any side effects, they will usually be limited to itching, redness, or dryness at the application site. Retinoids are chemically derived from Vitamin A and are useful for a range of skin conditions. If topical steroids are the typical first treatment for IGH, topical NSAIDs share second place with retinoids. Your doctor will start you on one of them and evaluate your results. NSAID creams such as pimecrolimus reduce inflammation and can help reduce the appearance of IGH spots over time.  Pimecrolimus 1% cream may cause localized burning or stinging, but these issues typically vanish after a few applications. It can also cause acne flares in the application area in some cases, but this side effect usually goes away fairly quickly with regular use. You'll often apply this medication twice per day for at least 2 weeks, and probably longer, in order to achieve results.
Ask your doctor about using topical steroids. Discuss using retinoids such as tretinoin. Consider trying a topical NSAID like pimecrolimus.