Doctor Appointment

(1). Hello Khazima As u described in given history...as PCOS alone usually does not cause widespread joint,heel and back pain.... Low hemoglobin may explain aa weakness, but u should be evaluated for other causes such as vitamin D or B12 deficiency, anemia, thyroid disorders, or inflammatory conditions....Basic blood tests (CBC, ferritin, vitamin D, B12, TSH, ESR/CRP) are advisable. Please seek medical evaluation for a proper diagnosis and treatment..

(2). Use cap canestin 1 vaginal tablet once, apply canestin cream daily for 7 days, for itching use tab piriton at night . Tab flagyl 400mg 1* 8 hrly for 5 days.

(3). U should continue with this treatment & follow lab results after 3 months to see effectiveness of treatment..

(4). I completely understand how frustrating it must feel to see..the pigmentation improve with treatment only to have it gradually return when u stop the creams... Please dont feel discouraged because Melasma is a chronic condition & recurrence is very common so that doesnt mean that ur treatment has failed.... The key is to focus on long term control rather than a permanent cure....Kindly Use daily SPF 50+ broad spectrum sunscreen preferably tinted/iron-oxide containing this is extremely important.... A dermatologist can also choose an appropriate maintenance cream based on ur skin type & previous treatments... Peels & lasers may help in selected cases bt they need to be used carefully as they can sometimes worsen pigmentation....so do go to some experienced dermatologist not just aesthetician...I would recommend a dermatology consultation to review the creams u have been using n make a safe personalized long term plan....With consistent care ur melasma can be significantly improved n controlled... I wish you best of luck.. Take this skin condition as part of ur body and deal it boldly.. Think it as many ppl are fighting more severe conditions so luckily its this skin condition n inshaAllah it will improve n u can control .....