Tips for Dark Spots, Hyperpigmentation, and Melasma
By Dr. Maxfield and Dr. Shah
Dr Maxfield says, "You can invest every single dollar in your bank account to treating your hyperpigmentation”, but “if you don’t wear sunscreen, every last penny was spent in vain”.
Dr Shah mentions that he spends half of his appointments counselling his clients on the importance of sunscreen. He adds, “We really spend a lot of time focusing on sunscreen sun protection and what kind of sunscreen specifically is going to have the most benefit.’’ He then suggests how to identify a good sunscreen – “When you look at the back of a sunscreen label, at the very top of the list, you’ll see active ingredients and then underneath it, you’ll have the other scattered ingredients. Now those active ingredients are things like octan oxate, zinc oxide, titanium dioxide but in the inactive ingredient section is where you want to look for the word iron oxides. Iron oxides help to block against that visible light that we do know causes hyperpigmentation in some people.’’
- Treat the Underlying Cause
To find a treatment for hyperpigmentation, we need to find what causes it. Dr Shah lists a few, “The sun, hormones during pregnancy, and inflammation. Inflammation can hyper activate those melanocytes they can also lead to hyperpigmentation.” Dr Shah concludes, “So right finding the underlying cause - critical, treating the underlying cause – critical; and I think that’s a common mistake that we see people making. Find out what’s causing your hyperpigmentation then direct treatment at it”.
- Using the Wrong Ingredients
"Another mistake that I see people commonly making, especially when they come in with another treatment regimen that they’ve come up on their own, is not using the ingredients correctly that they’ve found, or that they were prescribed, so these may be effective ingredients but they’re not being used appropriately and we commonly see this specifically with hydroquinone,’’ says Dr Shah. He adds that hydroquinone should only be used for short periods of time: two, three, four months under the control of a dermatologist. He adds, “If you use it long term, you run the risk of something called exogenous ochronosis.’’ This causes irreversible darkening and dark spots.
- Side Tip: Retinoids and Azelaic Acid:
Dr Shah says, “For people that are that are trying to treat their acne and their hyperpigmentation at the same time, then our two favourite ingredients is Retinoids and Azelaic Acid.” These two ingredients treat both acne and hyperpigmentation. So you’re treating the cause and the pigment at the same time.
- Skincare Routine
Dr Shah mentions that there are three main active ingredients in this category, and you wouldn’t necessarily use them at the same time, but at different times of the day and of the week. Both doctors mention that things like Vitamin C and Niacinamide are not potent enough to make a big difference in your skin. So stick to the following:
1) Hydroquinone, and some sort of Retinoid, 2) an Alpha Hydroxy Acid or Beta Hydroxy Acid and then 3) a moisturiser, and 4) a sunscreen.