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Strategies for Achieving Clearer and Brighter Skin

December 8, 2016 • the kimmel institute • Aesthetic Treatments

If you’re trying to achieve the holy grail of clearer and brighter skin, dark spots, known as hyperpigmentation, can be your worst enemy. There are several causes of hyperpigmentation, but there are also several treatments out there.  Which treatment is right for you? Topical Medications The gold standard for lightening dark spots is topical Hydroquinone.  Topical treatments like Hydroquinone block melanin production by inhibiting Tyrosine, an enzyme responsible for the production of pigment.  Because of its efficacy in reducing melanin production, Hydroquinone is a powerful tool in our arsenal in the hyperpigmentation war. We can maximize Hydroquinone’s potency by adding a topical retinoid cream to the mix, like tretinoin.  Tretinoin is a prescription topical medication derived from Vitamin A, which increases cell turn over and exfoliation of the skin.  Utilizing this combination therapy will yield better results than Hydroquinone alone, along with the added bonus of a reduction in fine lines and wrinkles from the enhanced collagen production and preservation effects of tretinoin. Hydroquinone therapy is safe to use in lower strength concentrations (4-6%) for treatment periods of no longer than 6 months, after which you should take 3-month break to avoid potential adverse effects from long-term use. Natural Skin Lighteners So what are your options during your break from prescription Hydroquinone therapy?  Natural lighteners available in cosmeceutical brands like Alpha-Arbutin (also called Bearberry Extract), Kojic Acid (a derivative of mushrooms), and Azalaic acid are the answer.  These products are great options after reaching your therapeutic goals with prescription medications, for maintenance therapy, or while on a Hydroquinone break.  Topical vitamin C, a powerful anti-oxidant, can also help with the regulation of melanin over time. Chemical Peels If you’re looking to jump start your path to more clear toned skin, chemical peels are powerful adjuncts to topical therapies and can be very effective.  There are many types of skin peals.  There are even designer peels like the Vi Peel Precision Plus, which is specifically formulated to treat Melasma or Cholasma, a hormonally mediated hyperpigmentation that is made worse by sun exposure. Depending on the cause of the hyperpigmentation and the depth of the pigment, glycolic acid peels are a great starter peel for most.  A Glycolic acid peel is safe for all skin types because it can be tailored to be more of a superficial peel, whereas caution must be taken with deeper penetrating peels for darker skin types. Laser/Intense Pulse Light Procedures Now what about laser and IPL treatments?  These are also options for improving hyperpigmentation, however, they are not for everyone.  For those with are darker skin tones (classified as Fitzpatrick skin types 4-6) laser and IPL are not considered as a first line treatment.  In fact, laser and IPL may even worsen hyperpigmentation in these skin types due to a potential post inflammatory response.  Laser and IPL may, however, be a viable option for very fair skinned individuals who can limit their sun exposure both before and after treatment to avoid adverse effects. Role of Sunscreen Finally, the importance of sunscreen for maintenance and prevention cannot be stressed enough.  For those with hyperpigmentation woes, it is imperative to use a broad spectrum sunscreen of 30-50 SPF, preferably one that contains a physical barrier like zinc or titanium oxide.  Sunscreen should be applied daily, even if you’re not anticipating a day of outdoor sun exposure, as up to 60% of UVA rays are able to penetrate glass. In Conclusion The bottom line to keep in mind is that ongoing maintenance with therapeutic topicals will most likely be required and the best hyperpigmentation treatment of all is prevention.

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