If the face is a canvas, many would prefer a one-tonal painter versus an artist fond of splashes of rainbow hues. As the beauty of skin is found in its uniformity and smoothness, dark blotches or redness can distract from the masterpiece that is you.
There are many causes of discoloration on the skin; which may due to pregnancy (melasma), medications (birth-control pills, hormones), sun-exposure, genetics (especially Asian and Hispanics), diseases (thyroid disorder), aging, and post rashes/wounds/scratches. Yet, not to despair, there are medicaments that help to fade discoloration and create a more even surface. Nonetheless, in the case of melasma or sun-spots, the stubborn nature of this condition, makes it necessary to have life-long treatments at the ready.
The most common and time tested ingredient used to lift pigment is hydroquinone, which helps to damage pigment producing cells (melanocytes & melanosomes) why decreasing tyrosinase. It is available as a 2% in store products like Ambi or Murad Environmental Shield Rapid Age Spot and Pigment Lightening Serum, but up to 20% via prescription. Using this or any bleaching cream is a slow process, over several months, which is best used in conjunction with other exfoliative or brightening beauty products.
However, if you are looking for an efficacious hydroquinone alternative, many companies are now heeding that request by using an age-old Chinese lightener. Kojic Acid creams present a great alternative, although difficult to source OTC, one remarkable brand is Meladerm.
Hydroxy Acids such as glycolic, salicylic, or other fruit acids are great for speeding up the shedding of the top layer of skin, thereby moving the next layer up, and revealing healthier smoother skin. A few great buys in this category are Garnier Skin Active Clearly Brighter Dark Spot Corrector, Nip + Fad Glycolic Pads, Exuvience Performance Peel AP 25, DERMAdoctor Ain’t Misbehavin’ Healthy Toner with Glycolic & Lactic Acid and Clinique Even Better Clinical Dark Spot Corrector.
Antioxidants are also of great usefulness in targeting free-radicals, as they reverse photo-aging and pigmentation. The most common antioxidants are Vitamin C, A, B3, and E, selenium, green tea, resveratrol, copper, caffeine, and CoEnzyme Q10. Although many products tout these ingredients only certain brands pack a more powerful combo. Search for La Roche-Posay Anthelios AOX Daily Antioxidant Serum With Sunscreen, Dermalogica Age Smart Overnight Repair Serum, and Dermadoctor Kakadu C 20% Vitamin C Serum with Ferulic Acid & Vitamin E.
Retinol is also a mainstay of therapy for photo-aging and aiding in the process of skin cell turnover to combat pigmentation. OTC brands may contain small amounts of a degraded version of Retinol, except for Differin Gel, the newest approved RX to OTC version of a true Retinol. This can be applied at night with hydroquinone (layering), while utilizing and antioxidant or hydroxy-acid in the morning with sunscreen as a finishing piece. Also look for the duo of antioxidant with Retinol in Dr. Dennis Gross Ferulic Acid + Retinol Brightening Solution.
Sunscreen is a potent protector in preventing sun-damage and discoloration. It must be used daily and reapplied with if sun exposure is prolonged, every four hours. Without this barrier, all the hard work that has been accrued with battling dark spots, will be easily lost as pigment regenerates. Cosmetically elegant brands of sunscreen have become available in products like Clinique Moisture Surge CC Cream Hydrating Colour Corrector Broad Spectrum SPF 30 or Clinique Even Better Clinical Dark Spot Corrector, Aveeno Positively Radiant Daily SPF, and Colorescience Daily UV Protector Whipped Mineral Sunscreen Broad Spectrum SPF 30.
As stated, stronger versions of hydroquinone, retinols, and antioxidants (cosmeceuticals sold in office) are available. Hydroquinone formulations with antioxidants or other lightening chemicals (Kojic Acid) blended in are also an option through prescription pharmaceutical compounding. One product with a triple combination already prepared is the RX Tri-Luma which includes hydroquinone, a retinoid, and a calming steroid.
Azelaic Acid is another category of medication that is often used for melasma and pigment disorders off-label. Although it is a much more mild skin depigmenter than hydroquinone, it is one that is safe to use during pregnancy. It is available in the brands of Azelex and Finacea.
Cosmetic In-Office Treatments
Pigmented patches can be best addressed with combination therapy, prescription treatments along with cosmetic procedures like chemical peels or laser. In-office glycolic, alpha, or beta hydroxy acid peels, which slough off the surface layers of skin, will decrease pigment with greater veracity than OTC products.
Lasers provide a more efficient plan of attack than chemical peels. Specific light spectrums or brands such a Ruby, YAG, or Alexandrite are best for dark spots. IPL (Intense Pulsed Light) is also an option for subtle pigmentation. Nonetheless, lasers must be used with caution in those with naturally darker skin tones, so discuss possible adverse effects and correct treatments for your skin type.
Overall, dark spots are a difficult skin problem to address. Pigment from sun or any of the applicable disorders, is a stubborn condition that can be considered a life-long battle. Nonetheless, with a good skincare routine in hand, pigment can be decreased and that leopard like look minimized.
*The information provided above or in any blogs on this site is for educational purposes only. I does not replace advice or necessary examination and diagnosis from your healthcare clinician. Please see your healthcare provider for any and all concerns with changes in your health or treatment of disease.*