This post goes out to Kelly and Katie, hang in there - help is on the way.

We are not alone, my friends. Most of us have some sort of skin abnormality to deal with. For me, it’s acne rosacea. For Kelly and Katie, it’s melasma. Melasma is a dark skin discoloration found on sun-exposed areas of the face, particularly common in women. People with light brown skin from regions of the world with intense sun exposure are more prone to develop melasma. A major factor is exposure to sunlight – ultraviolet radiation. However, more than a third of melasma patients have a family history of it. It has been linked to pregnant women and/or those women taking oral contraceptives or hormone replacement therapy medications. Melasma doesn’t happen overnight….it develops gradually, making it difficult to treat at the outset.

Creams and serums containing tretinoin, kojic acid and azelaic acid have been known to improve the appearance of melasma. Hydroquinone (HQ) is most commonly used. It is a hydroxyphenolic chemical that inhibits tyrosinase, decreasing the production of melanin. There are other forms of treatment, such as chemical peels or topical steroid creams. A chemical peel involves applying a peeling agent to the skin for a short period of time. The skin will peel similar to that of a sunburn. Although a number of studies have shown that treating melasma with superficial chemical peels and a bleaching agent is safe and effective, you should be aware of possible adverse effects such as post-inflammatory hyperpigmentation and hypertrophic scars. The most drastic of all measures is laser treatment to remove the dark pigment.

Regardless of the treatment you choose, it will be pointless if you continue to expose yourself to the sun. Okay, let me break that down….that means, Stay Out Of The Sun. Certainly daily sunscreen use helps prevent melasma – and bonus, it is crucial in the prevention of skin cancer and wrinkles.

I recently recommended Theraderm's NuPeel in combination with Enlighten to help lighten hyperpigmentation for Kelly and Katie. And while I think they are a great start in the treatment of melasma, a dermatologist consultation is highly advised.

Update:
Many dermotologists consider hydroquinone to be the most effective skin lightening ingredient available at this time and is the only skin bleaching agent approved by the FDA. The FDA limits over-the-counter concentrations of hydroquinone to 2%. Some prescription products can contain up to 10%. Although hydroquinone has been used in the US for more than 40 years for skin lightening, some studies over the last 25 years have shed light on potential side effects. However, they have yet to be proven conclusive.
The #2 anti-aging product is an antioxidant. There are so many great products out there, it becomes personal preference. Are you a serum kind a gal, cream or lotion? I like to switch up between serums and creams. Just know that you need one, applied twice daily. Not only will it help with cell turnover, but it will build collagen … which is ever so important with each ticking day.

Topical antioxidants are touted as being a good protector against environmental damage to the skin and may be effective in slowing down skin aging. However, their effect depends on skin permeability and ingredients. It appears that increasing oral intake of some antioxidants (tea, drops, pills) may additionally protect skin from free radicals.

I am a big tea drinker. White and green tea (loose leaf) are chock full of antioxidants and have so many health benefits that I could write a term paper on tea alone! I drink at least one glass of each, white and green, a day. I have also used Dr. Brandt’s antioxidant drops. Aside from fighting free radicals, green tea helps prevent cancer and is said to aid in weight loss. It strengthens the immune system, reduces stress and regulates blood sugar. And white tea has three times the antioxidants of green tea. Drink up!

For me, it's all about the ingredients ... the science behind the product. I have found that serums are best penetrated (immediately) into the skin and produce the best results.

Ingredients to look for in an antioxidant:
  • Vitamin C
  • Vitamin E
  • Vitamin A
  • Cysteine
  • Methionine
  • Selenium
  • Glutathione
  • Carotenes
  • Lycopene
  • Coenzyme Q10
  • Lipoic acid
  • Melatonin
  • Some polyphenols
  • Some flavonoids
On the horizon… There is a new category of anti-aging treatments aimed at preventing sugar from damaging skin. Excess sugar attaches to elastin fibers causing them to harden when we consume too many sweets. The direct result is glycation - a loss in skin elasticity, enabling wrinkles to occur more easily.
The #1 anti-aging treatment is a prescription retinoid. Topical retinoids boost cell turnover to fight fine lines. It baffles me, on a daily basis, the number of people I know that do not understand its importance. Well okay, it seems simple to me. Prior to visiting my dermatologist, I guess I would have to admit I didn’t quite understand the power of a retinoid. However, I must point out that I certainly knew the importance of visiting a dermatologist once I hit 30. Since then, it has become part of my annual or semi-annual routine for me. My skin has never looked better, brighter or clearer. Now in my late 30s, wrinkles are my worst enemy! I will do everything humanly possible to treat wrinkles while preventing new wrinkles from forming (if that is actually possible).

Using a retinoid:

You will apply your retinoid once a day, at night, 10 minutes after you have cleansed and moisturized your skin. It’s important, especially if you have dry skin, to let your night time moisturizer sink into your skin prior to applying a retinoid. If your skin can handle it, you can apply the retinoid before your moisturizer. Please note: if you are a beginner, go easy. Differin cream seems to be a good starting point for most (as was for me with sensitive skin and acne rosacea). You should use once every third day to see how your skin adjusts to the product before applying daily. If you experience any reactions, please consult your dermatologist. Within 6 months to a year, you may be able to graduate to the Differin gel, which is about the same strength as Retin-A Microgel (I switch up between these two). If your dermatologist confirms that your skin cannot handle a retinoid, ask for other prescription recommendations.

Buyer beware

It kills me when I hear “retinol products aren’t really necessary” from skin consultants (I won’t mention names). About 6 months ago, I was shopping with my sister, who is one year older than I and completely clueless to proper skin care. We went into a self-titled skin/beauty store to pick up an antioxidant for her. The skin consultants, both in their mid-twenties, had the gull to say that retinol products aren’t really necessary. Not really necessary….blasphemy! The moral here, your dermatologist knows best.