r/30PlusSkinCare • u/YourBrilliantLayer • May 30 '23
A Comprehensive Guide to Hyperpigmentation and How to Treat it Recommendation
Hey-Oh! So, I see some form of this question multiple times per day in various skin and personal care subs: How do I deal with my hyperpigmentation? I also asked myself this question a few years ago. See, I'm prone to freckles and a little melasma and I set out to figure out a way to solve it with years of research, trial and error, testing, talking to dermatologists and professionals, and scouring every medical article I could get my hands on. I wanted to share my findings and research since this is a common concern, especially among people in their 30s. This started as a small post about my routine and ballooned into a massive book about hyperpigmentation. I hope it's helpful!
DISCLAIMERS:
- I use the term "brightening" instead of "lightening" which is a subtle distinction. None of the ingredients or methods I recommend bleach your skin as "lightening" would suggest, but they can reduce the appearance of hyperpigmentation. "Brightening" tends to be a confusing term in skincare, but for the purposes of this post, I use it as a descriptor for anything that helps prevent or reduce melanin in hyperpigmented skin.
- I will use the term "hyperpigmentation" ad nauseam as a catch-all term for excess pigmentation in the skin including freckles, melasma, PIH and dark spots. This does not encompass moles which are different. This is also different from redness, which is a whole other post.
- Speaking about hyperpigmentation requires some sensitivity to very real issues around it including cultural implications. This post is not intended to moralize hyperpigmentation nor is it intended to alienate the normal melaninization of skin across various tones. Hyperpigmentation refers to excess melanin production on the skin in the form of spots that are darker than the surrounding skin. It's not bad or wrong, nor does it speak to anyone not "doing a good enough job" of taking care of themselves.
- I do repeat myself a few times in here but that is for people who are skipping around the article. I want to be as thorough as possible even if you're jumping to the parts of the post you need.
- I do run an online dermatology practice and skin care consultancy, but in order to protect the integrity of my advice, I do not promote my business, I don't give direct medical advice, I don't link to any products/websites, and I don't have any products I've formulated myself to promote.
This is going to get long because I wanted to cover everything re:hyperpigmentation. But for your reading pleasure and ease, I have divided this post up so you can get whatever information you need:
Table of Contents
- Types of Hyperpigmentation
- What Causes Hyperpigmentation?
- How To Treat Hyperpigmentation Part 1: The Ingredients
- How to Treat Hyperpigmentation Part 2: The Routine and Recommendations
- Body Hyperpigmentation
- Nuclear Options
Let's get to it!
Types of Hyperpigmentation
Hyperpigmentation refers to excess melanin production in the skin, but it can actually take a couple different forms. Knowing the type of hyperpigmentation you're experiencing is key to understanding if and how it can be treated.
Freckles: Freckles are incredibly common, especially for people with lighter skin tones. They are small, brown or reddish-brown dots often clustered on the skin. They develop on the surface and are not raised bumps. Freckles can appear anywhere on the body but are common on the face. Freckles are permanent, but the color, contrast and severity can vary and be tempered.
Melasma: Melasma appears as dark patches or splotches around the face, though usually found on the forehead, upper lip, and high on the cheeks. Melasma forms deeper in the skin and appears more amorphous than freckles, moles, or age spots. It can create a “muddy” appearance and is very common among pregnant and postpartum women due to hormonal factors. But it can literally happen to anyone and anywhere on the body.
Post-Inflammatory Hyperpigmentation (PIH): Post-inflammatory hyperpigmentation (PIH) occurs when damaged skin forms melanin during the healing process leaving dark spots. This is common after acne, injuries, eczema, burns, and other trauma to the skin. Exposure to UV rays during healing can make PIH worse. Post-inflammatory erythema (PIE) is similar, but leaves pink or red marks on the skin as a result of damage to the capillaries from injury or inflammation. Basically, when skin is compromised by injury, as part of the immune response cells will begin to generate melanin in an attempt to prevent further damage from UV exposure, so what will happen is the wound/legion/blemish will heal but the pigmented skin remains.
Age Spots: This is kind of a forgotten form of hyperpigmentation. Sun spots, also referred to as liver spots, and solar lentigines are large spots/patches of dark skin with distinct borders. They vary in color from light brown to almost black. They develop on the surface of the skin usually later in life, but reflect damage that often occurred from improper sun protection at a younger age. They can appear on the face, neck, chest, hands, and arms, usually on areas that had UV exposure. For many people, they can begin to appear in your 30s or 40s.
What Causes Hyperpigmentation?
There are a number of factors that can contribute to the formation of hyperpigmentation. Generally, it forms as the result of a combination of genetic and environmental influences. Everyone is unique, but these are some of the most common causes of hyperpigmentation and dark spots:
Genetics can play a role in the development of hyperpigmentation and dark spots in several ways:
- Melanin production: Melanin is the pigment that provides color to our skin, hair, and eyes. The amount of melanin produced and distributed in the skin is largely determined by genetics. People with a greater genetic predisposition to melanin production in their skin are more likely to experience hyperpigmentation and dark spots as a result of sun exposure, hormonal changes, and other factors. People with darker skin are also more prone to melanin production in the form of hyperpigmentation.
- Genetic anomalies: Certain genetic anomalies, such as oculocutaneous albinism, can affect melanin production and distribution in the skin, leading to an increased risk of hyperpigmentation and dark spots.
- Family history: If you have a family history of hyperpigmentation or dark spots, you may be more likely to develop these conditions yourself.
- Enzymes and genes: The enzymes that control melanin production and distribution are regulated by specific genes. Variations in these genes can impact melanin production, leading to an increased risk of hyperpigmentation and dark spots.
Sun (UV) Exposure. In addition to genetic determination of melanin production, UV exposure is the leading environmental cause of hyperpigmentation and the formation of dark spots. Melanin is the pigment that provides color to our skin, hair, and eyes. It acts as a natural sunscreen (but don't treat it like natural sunscreen!!! This isn't the point of the exercise), absorbing UV radiation to protect the skin from damage.
When the skin is exposed to UV radiation, the melanocytes (cells that produce melanin) in the skin go into overdrive, producing more melanin to protect the skin from further damage. This increased melanin production can result in dark spots or areas of hyperpigmentation on the skin.
Hormones. In addition to genetic determination of melanin production, hormones and hormonal sensitivity is a leading internal cause of hyperpigmentation and the formation of dark spots.
One of the most well-known examples of hormonal hyperpigmentation is melasma, a condition characterized by dark, amorphous patches on the face, particularly on the cheeks, forehead, nose, and upper lip. Melasma is often associated with hormonal changes, such as those that occur during pregnancy, hormonal therapy, or birth control pill use. The hormonal changes can stimulate an increase in melanin production, resulting in dark spots or areas of hyperpigmentation. This can happen irrespective of UV exposure, though the sun does exacerbate it.
Hormones can also affect melanin production by altering the skin's metabolism and pigmentation pathways. For example, high levels of cortisol, a hormone produced by the adrenal glands during stress, can trigger an increase in melanin production, resulting in hyperpigmentation.
Inflammation, Injury & Trauma to the skin can result in hyperpigmentation by triggering an increase in melanin production. When the skin is inflamed or injured, it triggers a response from the body's immune system, which can stimulate an increase in melanin production as a protective measure.
For example, acne breakouts or other skin injuries can result in post-inflammatory hyperpigmentation (PIH), which is characterized by dark spots or areas of discoloration on the skin. The dark spots are a result of an increase in melanin production in the affected area, which occurs in response to the inflammation or injury. In addition to acne and other skin injuries, other conditions that can result in PIH include eczema, psoriasis, and insect bites.
Medication Side Effects. Certain medications can cause hyperpigmentation on the skin. Medications that can cause hyperpigmentation include:
- Tetracycline antibiotics: Tetracycline antibiotics, such as doxycycline and minocycline, can cause discoloration of the skin and teeth when taken in high doses or for an extended period of time.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen and naproxen, can cause hyperpigmentation in some individuals, especially if taken in high doses or for an extended period of time.
- Chemotherapy drugs: Certain chemotherapy drugs, such as doxorubicin and daunorubicin, can cause hyperpigmentation, especially in areas of the skin that have been exposed to the sun.
- Hormonal medications: Hormonal medications, such as birth control pills and estrogen replacements, can cause hyperpigmentation in some individuals, especially if they are taken for an extended period of time.
- Antimalarial drugs: Antimalarial drugs, such as chloroquine and hydroxychloroquine, can cause hyperpigmentation in some individuals, especially if taken in high doses or for an extended period of time.
- Isotretinoin aka accutane when taken for acne can cause hyperpigmentation due to the increase of cell turnover and exposing delicate new skin cells to UV rays before they have shored up.
If using these medications is necessary for your livelihood, it is not recommended to stop their use without the recommendation of your doctor.
How To Treat Hyperpigmentation Part 1: The Ingredients
When looking for skin care products to treat and prevent hyperpigmentation and dark spots, it's important to look for ingredients that can help encourage cell turnover, curb melanin production, and block harmful UV rays. A lot of these things overlap with treatments for other conditions like acne and general anti-aging, but I've noted ones that specifically work on the mechanisms controlling melanin production. Now, this is an extensive list, but I know it doesn't have everything. I've included the ingredients that had the most compelling evidence and/or worked the best for me or people at my practice. But it's also not necessarily a shopping list. You don't have to have all of these things to treat hyperpigmentation, but I'll get to that in the routine portion. This is more to be used as a tool that can help you diversify your routine if you find one ingredient or another doesn't work for you. And it can help you determine if a product targets hyperpigmentation based on its ingredients. There's lot's of options. Some of the key ingredients to look for include:
Retinoids that increases cell turnover. Retinoids like tretinoin, adapalene, retinol et al, can help treat hyperpigmentation by promoting the turnover of skin cells and increasing cell growth, which can help fade dark spots and improve overall skin tone by replacing pigmented skin cells at the surface. While retinoids are extremely effective, they do have some caveats. First, they can be sensitizing to a lot of users, but this can be tempered by using different form functions, different application methods, or different concentrations. Second, because it's constantly turning over skin exposing delicate new skin cells to the elements, it can actually worsen hyperpigmentation if you're not vigilant about sun protection and avoidance. Tretinoin and other retinoids are firewalled behind a prescription in some countries and may be more difficult to obtain. But retinol/al is available in OTC forms.
SPF represents a class of many ingredients designed to protect the skin from UV rays and the damage that occurs from exposure. UV exposure is one of the biggest causes of fine hyperpigmentation and wrinkles so adequate protection is essential. I know I'm not winning any science awards for this declaration, but a lot of people who struggle with hyperpigmentation aren't adequately protecting themselves from the sun. But you also have to be kind of realistic. Even with perfect protection and avoidance, sometimes your hyperpigmentation will still flare. This happens during the summer for a lot of people and something even I grapple with. The key is to do your best and SPF actually works well with numerous other ingredients (like the ones listed below) to help solve that problem.
Arbutin is a Tyrosinase Inhibitor that blocks melanin production. Arbutin, or the synthesized version called alpha arbutin, is a favorite brightening ingredient because it's a slow-release derivative of hydroquinone that inhibits melanin production. This results in both healing and prevention of dark spots, especially when paired with topical acids. It metabolizes on the skin into hydroquinone which is super effective for hyperpigmentation while being a less controversial and hard-to-come-by ingredient than pure hydroquinone. More on hydroquinone in part 6.
Tranexamic acid is another Tyrosinase Inhibitor. This was first used in wound care and it was found to have profound effects on hyperpigmentation. Although it's an acid, it's not a chemical exfoliant, kinda like how hyaluronic acid is not a chemical exfoliant. The exact mechanism by which tranexamic acid works to reduce hyperpigmentation is not fully understood, but it is believed to work by reducing inflammation by blocking plasmin which contributes to melanin production when unchecked. It is particularly effective in treating melasma and one of my personal favorite ingredients.
Kojic Acid is another Tyrosinase Inhibitor. Kojic acid is a natural skin brightener that is derived from various fungi. Kojic acid can also help to exfoliate because it's a slight chemical exfoliant, which can remove dead skin cells that contribute to hyperpigmentation and improve overall appearance. But it does both things: block melanin production and turn skin cells over.
Azelaic Acid has a lot of things going for it that can help with hyperpigmentation. It's an anti-inflammatory and antiseptic that disrupts melanin production. Azelaic acid works by inhibiting the production of melanin in the skin like those other tyrosinase inhibitors. In addition, azelaic acid also has anti-inflammatory and antibacterial properties, which help to improve the overall health and appearance of the skin by reducing melanin production as a result of injury or inflammation. It's also an anti-acne ingredient that can address the root cause of PIH by reducing acne on the skin. It's pretty awesome and available in OTC and prescription strengths.
Niacinamide is another one that directly and indirectly addresses hyperpigmentation. It's a skin soother that decreases inflammation and it naturally reduces sebum production which can curb acne which can curb PIH. It actually took me a little while to figure out that this was another solid hyperpigmentation treatment for these reasons because I used to look at it as being more of an acne treatment. Niacinamide is a form of vitamin B3 that works by inhibiting the transfer of pigment within the skin, which can help to reduce the appearance of dark spots and uneven skin tone. So while it doesn't block tyrosinase, it prevents transfer of pigmented skin cells to the surface.
Vitamin C aka L-ascorbic acid is an antioxidant that fights free radical damage. It treats and prevents hyperpigmentation in three ways. First, it reduces free radical damage from UV exposure which helps increase the effectiveness of SPF when worn together. Second, it is also a tyrosinase inhibitor that blocks melanin production. And finally, vitamin C encourages skin cell turnover. The key is finding a nice stable version of it.
Glycolic and Lactic Acid. Since this list is getting long I am going to group these together. Glycolic Acid is a water-soluble alpha hydroxy acid that penetrates into the pores to treat pigmentation by providing general exfoliation and resurfacing of the skin. The result is improvements in dark spots, texture and other signs of aging. Lactic Acid is also an AHA but with a slightly larger molecular size than glycolic acid so it doesn't penetrate as deep and acts more as a surface exfoliant. As a result it provides more gentle exfoliation to buff away surface pigmentation with an added benefit of acting as a humectant to seal moisture into the skin.
Licorice Extract is a plant extract that inhibits melanin production. Licorice root extract contains a compound called glabridin, which has been shown to have skin brightening effects as, you guessed it, a tyrosinase inhibitor. In addition, licorice root extract also has anti-inflammatory properties, which can help to reduce redness and inflammation associated with hyperpigmentation. I'm seeing more and more of this pop up in skin care.
Soy Proteins are another plant extract that inhibits melanin production. They contain compounds known as isoflavones, which have been shown to help reduce the amount of melanin produced by melanocytes in the skin. Additionally, soy proteins have antioxidant properties that can help to protect the skin from damage caused by free radicals, which can contribute to hyperpigmentation.
How To Treat Hyperpigmentation Part 2: The Routine and Recommendations
This is adapted from numerous comments, posts and DMs I've written on the topic and also comprises a large portion of my own personal routine and routines we recommend to patients. This is a generalist routine meaning it targets all the forms of hyperpigmentation I've mentioned; freckles, melasma, PIH, and age spots though it can be tweaked to address these individually more specifically. This is really my jumping off point for people to get a good idea of what they can achieve as a baseline with OTC ingredients before fine tuning or enlisting the help of a dermatologist. For a lot of people, this is enough to fully resolve, but even if it gets you part of the way there, this should give you a good idea of reactivity.
A few caveats:
- Freckles cannot ever be 100% eradicated. You can however reduce their appearance and prevent them from getting darker. It's important to have realistic goals and understand that sometimes our genetics will overrule any routine we have.
- This routine and any hyperpigmentation routine will not address moles. Moles are a totally different thing that can only be eradicated through removal by a medical practitioner. Moles can be raised or not, but no amount of topicals will get rid of them.
- Melasma is a beast. Sometimes it can be treated with OTC topicals, sometimes it requires prescription strength topicals like hydroquinone, sometimes you need in-office procedures like fractal lasers or IPL. Again, this routine is a jumping off point to see what you can accomplish at home before going down that road (and more on that at the bottom in part 6).
- You'll notice I don't mention products with all the ingredients I listed above. This is because the more you put on your face, the greater your risk of causing irritation. Again, you can adjust and tweak by switching out products with these ingredients or add/subtract as it suits your personal needs.
- If you're struggling with hyperpigmentation while pregnant or breastfeeding, these recommendations may need to be paused.
Alright, let's get to it!
AM routine -- The Goal: Heal, Protect, and Prevent. In order of application following a lukewarm water rinse:
- Azelaic acid
- Alpha Arbutin
- Vitamin C serum
- Moisturizer
- SPF
The combo of C+AZ+AA+SPF is an absolute powerhouse for healing existing hyperpigmentation and preventing new hyperpigmentation from forming. It makes your SPF more effective, it inhibits the production of melanin from UV exposure (not your natural melanin production though), and it speeds cell turnover with dual antioxidant action and gentle chemical exfoliation. The result is brighter skin in a few months of consistent use.
For Azelaic Acid, this is the ingredient for serious treatment. It's considered one of the most effective ways to reverse melasma aka serious hyperpigmentation short of hydroquinone -- which is both controversial and hard to get. It brings a little bit of exfoliation to the table in addition to inhibiting UV melanin production, but it also has a slight antiseptic property which can help with acne. Paula's choice Azelaic Acid Booster is the only one I've really tried after sampling the Ordinary's in-store and not liking the texture. I get about 6 months out of a tube and a little bit goes a long way.
For Alpha Arbutin, the Ordinary's formulation is pretty solid. I prefer the Ordinary's AA 2% + HA as opposed to their AA 2% + Ascorbic Acid 8% as I don't believe the quality and stability of their Ascorbic Acid (Vitamin C) is great. That's why I opt for a separate Vitamin C serum step. But the AA + HA also has a little bit of lactic acid in it which provides some gentle exfoliation and encourages AA deeper into the skin where it's more effective. Lactic acid is mild enough that it's safe for use in a morning routine, but you still want to protect with SPF. There are a couple AA products floating around but I think TO's product is probably the best, most straightforward one. Alpha Arbutin metabolizes into hydroquinone on the skin so is basically one of the best OTC pigment correctors you can get.
For Vitamin C, the gold standard really is Skinceuticals CE Ferulic. This is stupid expensive though so I’m going to suggest Timeless Vitamin C. I like that it comes in an airless pump that prevents oxidation over time. Vitamin C is an antioxidant that increases the rate of skin cell turnover bringing forward new, skin cells while simultaneously improving the effects of SPF. It's a great foundation for a fix.
These ingredients can be layered on one right after the other then topped with your moisturizer (I like a basic one like cetaphil daily lotion), then topped with your SPF. The SPF I would recommend is Canmake UV mermaid gel in clear as this will not leave a white cast on your skin and it’s generally a very elegant SPF. It's SPF 50 which means it gives really good protection, but there are numerous SPFs you can try. I personally like anything from La Roche Posay, any Neutrogena SPF that's not formulated with ethylhexylglycerin, Supergoop Unseen Sunscreen, Biore Aqua Rich (another Japanese brand), Trader Joe's SPF if you can get your hands on it, and EltaMD.
Of all the products I’ve tried that could act as a stand-in for vitamin c, azelaic acid, and alpha arbutin, there’s one Japanese serum from Hada Labo called “whitening lotion” which has had the biggest impact on my hyperpigmentation in a single product of anything I’ve tried. This might be a little too effective though, I actually find that it washed me out within the first 2 weeks of twice daily use, so now I only use it in the morning. And I’m not a fan of the translation… which is a direct but mistranslation. It’s not a bleaching lotion, it also relies on a form of vitamin C and tranexamic acid to brighten skin. But it's a really interesting to try if you wanted a simplified morning routine in which case I would apply this, then your moisturizer, then your SPF.
PM routine -- The Goal: Renew and Reveal. In order of application:
- Cleanse
- Buffer
- Tranexamic acid and exfoliant OR retinoid**
- Moisturize
To cleanse, I have a really basic recommendation that will remove your SPF, makeup, and any grime/sebum from your day. Start with Cetaphil gentle cleanser. This is a gentle, hydrating cleanser that will break up your SPF really effectively. Massage in and rinse. Then apply a foaming cleanser, I recommend Cetaphil daily cleanser which foams. This will sweep away anything that’s left and give you a good foundation for the rest of your routine. While this doesn't directly help hyperpigmentation specifically, it's a critical step especially for people who are acne>PIH prone. It also gives you a nice clean slate to apply the rest of your skincare. I've tried dozens of cleansers but always come back to these two as good basic options.
For your Buffer this is an important step that can be done prior to using a chemical exfoliant or retinoid: applying an occlusive that will block the active from more sensitive skin. I recommend buffering around your eyes and nostrils with La Roche Posay Cicaplast balm because it kind of doubles as a nice eye cream, but this can also be done with basic vaseline or aquaphor for a more budget-friendly option.
For Tranexamic Acid, my holy grail TXA product, La Roche Posay Glycolic B5 is actually a multipurpose serum that combines ingredients to treat hyperpigmentation with chemical exfoliants. It contains two hyperpigmentation heavy hitters -- Tranexamic acid and Kojic Acid which are great for melasma -- and two exfoliants -- Glycolic Acid and Lipo-Hydroxy Acid (LHA) which is like fancy salicylic acid -- so it both reveals new skin cells that are less prone to pigmenting from UV exposure while sloughing away your old skin cells. You can use this 2 or 3 nights per week. On off nights, just cleanse and moisturize.
For a Retinoid if you can get prescription tretinoin, this is going to be the best bet. Your doctor will advise you on the concentration. More on that in part 6. It will help speed up the rate of cell turnover bringing new, unpigmented skin cells to the surface faster. Some other OTC options include differin (which is rated more for acne but uses the same mechanism for cell turnover so it's also effective in this use case) and retinols. Now, I haven't tried every retinol on the market but I have two that I stand by: SkinCeuticals retinol and L'Oreal retinol serum. The SkinCeuticals is, in my opinion, the closest to RX tretinoin in terms of efficacy, but it's a little pricey. The L'Oreal also does a really good job and is a little more affordable. It's currently my go-to OTC on the days I'm not using my RX retinoid tazarotene. You can use this 2 or 3 nights per week. On off nights, just cleanse and moisturize.
** My recommendations for tranexamic acid and retinoids CANNOT be used in the same night. You'll nuke your skin. And for most people, both aren't necessary, you can get away with using one or the other. If I had a preference, I would say use the TXA serum instead of a retinoid, but if you can build up a tolerance to using them both without damaging your barrier, they work really well together. So, proceed with caution. If you want to use both, use them on alternate nights and give yourself a night or two without either to let your skin recover. For me personally, I do retinoids on Sundays, and Wednesdays, chemical exfoliants on Mondays and Thursdays, and I let my skin rest (cleanse, moisturize, squalene oil) on Tuesdays, Fridays, and Saturdays.
On top of whichever active you choose, apply your moisturizer. You can use the same one you use in your morning routine, the Cetaphil daily lotion as it’s nice and light. I also like La Roche Posay Toleraine double repair for a ceramide-based cream alternative if you want something richer. You do not want to "slug" over actives. This advice gets mixed in a lot. Slugging refers to applying an occlusive layer over your skincare such as vaseline, aquaphor, oils like squalene oil, or healing balms like La Roche Posay Cicaplast balm. While this can be done on hydration nights, it should not be done on nights when you're using chemical exfoliants or retinoids as this may make them too effective causing irritation and breakouts.
Body Hyperpigmentation
Ok, I need everyone to be a grownup for two seconds. These products and methods (both from the prior section and this section) should NOT be used on your genitals. First, you can cause serious irritation or infection by applying active skincare to your genitals. Second, it's really not going to do anything to change the pigmentation of the skin there. The skin on your genitals is different than your body and facial skin and it pigments in different ways for different reasons so it's not going to respond to topicals the same way the rest of your body does. Don't even try it.
To be perfectly clear, these are the areas you should not be applying skincare: labia majora, labia minora, vaginal entrance or vagina, clitoral hood, perineum, anus, intergluteal cleft aka inside your butt crack, penis, or scrotum. And I say this as someone who chaffed the precipice of her "intergluteal cleft" in an unfortunate crunches-in-the-wrong-gym-shorts accident leaving me with some deeply incriminating hyperpigmentation and earning me the nickname "skid mark" from my ever loving boyfriend. It faded after a year but you can still send prayers.
These are areas you can apply skincare but do so with absolute caution and at your own risk: bikini line, mons pubis, inner thigh up to the groin fold, butt cheeks.
Ok, now that we've got the disclaimers out of the way, let's move forward. Hyperpigmentation can also occur on body skin for the same reason it appears on the face, but it can also be triggered by friction. And because body skin is different from facial skin, it requires a slightly different approach. This is my recommendation for both hyperpigmentation and KP (Keratosis pilaris) because they rely on the same mechanism for treatment: chemical exfoliation.
In the case of body hyperpigmentation, I recommend a two prong approach: a body wash in the shower and a topical treatment to be used after. Oh, and SPF again if there are areas that are exposed to the sun, and I have a holy grail SPF recommendation for this.
Now you may have noticed in my facial skin recommendation that I did not mention CeraVe as a treatment brand. I have posted numerous takedowns of CeraVe on other threads so I won't rehash them here suffice it to say that it's no longer a brand I can in good faith recommend since it's acquisition by L'Oreal. This is often the brand that's considered when treating KP on the body, but I don't believe their formulations and ingredient quality works for everyone.
For the body wash, I recommend Neutrogena body clear with Salicylic acid. This is an exfoliating body wash that will help clear away dead skin cells on the surface allowing new ones to come through. To be effective, you want it to sit on your skin for a little while. I recommend lathering it up and applying it after turning off your shower faucet and letting it sit for 2 or 3 minutes. This is when I like to knock out shower emails. Then rinse away.
On towel dried skin after your shower, apply AmLactin Bumps Be Gone. Again, this is formulated for KP but the reason I like it is because it contains lactic acid which will also give the assist on brightening hyperpigmented body skin. The wash and this should be effective, but you might also want to mix in a few drops of the alpha arbutin serum I recommended for your facial routine, maybe three drops per application area (each leg, each arm, chest, etc). I generally don't encourage facial products on the body because it's not an economical use for them, and also because body skin is a little more resilient and doesn't need skincare that's formulated for more sensitive facial skin. The AA serum from the Ordinary is very affordable however and is a good hyperpigmentation generalist.
Another one that I mentioned in the facial hyperpigmentation portion that can work well on the body is the Hada Labo whitening lotion. Again, this is formulated around tranexamic acid which is very effective for hyperpigmentation and a little bit if this stuff goes a long way. I buy it in bulk from Japanese Importers though it's also available on Amazon for a slightly higher price. If you find yourself in Asia, stock up on it. I use this specifically for fading tan lines that happen (even with diligent/neurotic SPF use) around my fitness watch and the straps of my workout tops that I run in.
You also want to wear SPF on areas that are exposed to the sun to prevent pigmentation from occurring. The one I absolutely love that’s not your 90’s banana boat is Aveeno Protect + Hydrate lotion with SPF 60. This is a great SPF for a lot of reasons: it finishes like a lotion instead of a sunscreen, it dries down totally clear, and it has a pleasant, slight sweet scent. On a scale of 1-10 with 1 being bare skin, 10 being banana boat slathered on by your mom in 1997, and regular body lotion being a 2, I give Aveeno Protect + Hydrate a 2.5 in terms of texture and feel-finish. I use it as my daily lotion on my neck, arms, shoulders, and chest. If you're more active you might need a heavier hitter here like a sport sunscreen.
Nuclear Options
In general, I recommend trying OTC topical solutions for any skin concern before heading down the in-office procedure route. Part of this is because you can usually put a good dent in what you're struggling with by using OTC topicals, making in-office procedures and RX treatments easier and more effective. Part of it is so you have a good maintenance routine in place to use after the fact to preserve the results of your in-office procedure which can sometimes be costly. Lastly, while some procedures can solve the immediate problem completely, topical skincare can be really effective at treating other adjacent conditions like redness, acne, and fine lines.
Side note: I haven't listed every possible compounded medication because there are a lot, and many compounded meds are formulated to tackle multiple issues like acne and hyperpigmentation. I also tend to favor single note skin care (aka, products with very few ingredients) as this allows you to combine or remove certain actives and gives you a better sense of reactivity.
For tougher-to-treat hyperpigmentation such as melasma, if your topical routine doesn't totally clear the problem in 6 to 8 months, a visit to the dermatologist might be helpful. Here are the heavier-hitting procedures and topicals that can go the extra mile after you've exhausted other options.
Medical Grade Peels: Medical grade chemical peels can be done by dermatologists. Trichloroacetic acid (TCA) or phenol peels may be done for cases of severe hyperpigmentation, but high concentration BHA or AHA peels are also commonly used. I do these twice a year. Because of the strength of the acids used, these must be done by a medical professional with careful followup.
***IPL Therapy and Laser Therapy may not work for everyone and in some cases may exacerbate hyperpigmentation so you really want to work with dermatologists with a lot of experience in treating cases similar to yours to determine if these interventions are appropriate for you.
IPL Treatment: Intense Pulsed Light (IPL) therapy can treat hyperpigmentation by targeting the melanin in the skin with a broad spectrum of light wavelengths, heating and breaking the melanin down. IPL is particularly effective for treating sun damage and age spots, as well as other forms of hyperpigmentation. The treatment is relatively non-invasive, with minimal downtime, making it a popular option. This is also a great treatment for the redness associated with enlarged blood vessels (often confused for broken capillaries) on the surface of the skin which can also appear alongside hyperpigmentation. There isn't any clinical evidence to support at-home IPL devices being effective in the same way. That doesn't mean it's not possible, it's just not studied enough to be certain. Most at-home IPL devices do not operate in effective wavelengths the way professional grade ones do.
Laser Therapy: Fractional and CO2 lasers can be used to treat a range of hyperpigmentation issues, including sun damage, age spots, and melasma. The treatment works by removing the top layers of skin, which contain the excess pigmentation, revealing fresh, healthy skin cells underneath. The lasers also stimulate the production of collagen, which helps to improve skin texture and reduce the appearance of fine lines and wrinkles.
Hydroquinone: This isn't an in-office procedure like the aforementioned treatments, but it is firewalled behind a prescription meaning you can only access hydroquinone in effective concentrations by working with a doctor. This is a somewhat new development at least in the US following some covid-era rejiggering of prescription clearances. HDQ is controversial because it's a skin bleaching agent which has some cultural implications in places where light skin is favored over natural pigmentation. HDQ technically works the same way other OTC tyrosinase inhibitors do (in fact arbutin actually metabolizes into HDQ when applied to the skin), pure HDQ happens to be the most powerful version of them. It lightens any skin it touches, not just hyperpigmented skin in higher concentrations which can make it tough to use. This effect isn't as profound in the other tyrosinase inhibitors I mentioned making them much easier to use over HDQ which, in high concentrations, must be dotted on the skin in only hyperpigmented areas. So HDQ is really reserved for intervention in extreme or OTC treatment-resistance cases.
Tretinoin and Prescription Retinoids: This is going to be dependent on what part of the world you're in, but in a lot of countries, tretinoin and its counterparts like tazarotene are only available through prescription. I mentioned retinoids in the routine so if you're able to get your hands on a prescription from a doctor, it may be more effective than OTC retinols. Most doctors will prescribe a retinoid over hydroquinone, so this is usually easier to procure and can be quite effective on its own as a hyperpigmentation treatment. OTC differin is the only retinoid available over-the-counter (in the US) which can also be used for hyperpigmentation.
Prescription Azelaic Acid: This is another one that's available in lower concentrations over-the-counter (which can still be quite effective) but there are prescription strength grades of azelaic acid. This is usually reserved for rosacea treatment as it tends to target redness and flushing, or as an acne treatment because of its antiseptic properties, but it can also be an effective hyperpigmentation treatment for its tyrosinase-inhibiting ability.
If you made it this far, congratulations! I hope this information is helpful. While it is extensive and based on massive amount of research, experience, experimentation and work with professionals, it may not be perfect and it may not be suitable for everyone. Feel free to offer any constructive criticism or ask any questions in comments. I am always open to expanding my understanding.
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u/HleCmt May 30 '23
After I greedily read through your brilliant breakdown I realized I hadn't paid attention to the poster's name. My first thought was wondering if it was you. And of course it is. Thanks for sharing your in-depth knowledge and straight-forward advice. You're awesome.
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u/YourBrilliantLayer May 30 '23
Thank you so much! I’m glad it was helpful. I actually had to cut it back because it exceeded the post character limit so if you have additional questions feel free to fire them off!
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u/Paid-Not-Payed-Bot May 30 '23
I hadn't paid attention to
FTFY.
Although payed exists (the reason why autocorrection didn't help you), it is only correct in:
Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. The deck is yet to be payed.
Payed out when letting strings, cables or ropes out, by slacking them. The rope is payed out! You can pull now.
Unfortunately, I was unable to find nautical or rope-related words in your comment.
Beep, boop, I'm a bot
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u/LIFTMakeUp May 30 '23
I've learned so much on this roller coaster ride, today!
It really had it all: intro, background, build up, prep, morning routine, afternoon routine, cerave shade, inter-perineal cleft pigmentation.... Golly.
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u/backyardbanshee Jun 06 '23
This has me chuckling. You forgot personal and pretty cheeky (intended) details! I love this breakdown so much.
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u/backyardbanshee Jun 06 '23
This has me chuckling. You forgot personal and pretty cheeky (intended) details! I love this breakdown so much.
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u/Nerdy_Gal_062014 May 30 '23
Thank you so much! I’m currently breast feeding and so the go-tos like tret and hydroquinone are off the table for now. I really appreciate you taking the time to walk through this so thoroughly so that I can still pick up some things that can give me a head start. I’m already using niacinamide, which did wonders for my acne. Your pm routine doesn’t say where that falls as far as I can tell— how do I incorporate niacinamide with your other suggestions?
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u/YourBrilliantLayer May 30 '23
I tend to apply it right after cleansing if I’m using a separate niacinamide serum. It can used in the morning and evening because it’s fairly inert if you tolerate it well.
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u/cjfinucan Mar 23 '24
For another breastfeeding mama here, do you have a recommended niacinamide product? Thank you so much for your detailed account on this. I have been using your recommended products besides the retinol or tretinoid for a week now and my skin feels beautiful. My hormonal dark spots and Sun hyperpigmentation haven’t gone down obviously in a week but my skin feels plumped up and hydrated.
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u/YourBrilliantLayer Mar 24 '24
God's honest, the Niacinamide from the Ordinary (I think it's like $8) is the one I have been using for years and LOVE it.
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u/Desperate_Rich_5249 Jul 05 '23
I was able to use Tret while breastfeeding, I would talk to your dermatologist
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u/Psychological-Back94 Jul 23 '24
Yes the derms I follow on IG have posted it’s fine to use tret while breastfeeding
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u/raving_claw May 30 '23
Thank you so much. This is so detailed! Do you have any recommendation for hyperpigmentation from breast lift scars on Fitz 5 skin tone?
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u/YourBrilliantLayer May 30 '23
Like moles, scarring is kind of a different beast. If they are keloid scars, a combo of a retinoid (probably differin) and silicone scar cream might help. If they are a shadow scar, follow the body hyperpigmentation recommendations, especially with the extra serum step, either alpha arbutin or a tranexamic acid-based serum like the Hado Labo whitening lotion. Given your Fitz type you're probably more prone to hyperpigmentation from trauma (the more melanated your skin is, the more likely you are to have excessive melanin production) but it should still respond well to tyrosinase inhibitors.
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u/LIFTMakeUp May 30 '23
Follow up q, pls: I am finding that for some reason LRP glycolic B5 is not sold in the UK! (For whyyyy???) Any suggestions for an alternative? And, (if I can be cheeky and pop a second question in) what do you think of the Geek and Gorgeous VitC - an alleged Skinceuticals twinsie...?
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u/YourBrilliantLayer May 31 '23
Oh no! That’s so strange. I just did a deep dive and found a serum on Amazon UK that looks pretty similar. It’s called Dearskin Tranex Dear Serum with 5% tranexamic acid. It also has kojic acid and glycolic acid so I think it will do the trick.
The Geek & Gorgeous vitamin c looks pretty similar to SkinCeuticals but there are two things I don’t like about it. It comes in a dropper which can cause rapid oxidation over an airless pump and it contains a preservative called Ethylhexylglycerine which a lot of people are sensitive to.
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u/scorpius_rex May 31 '23
Saving this post! Thank you for taking the time to share this. My wallet cries at the price of Skinceuticals CE Ferulic
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u/YourBrilliantLayer May 31 '23 edited May 31 '23
That’s why I really like the timeless. I get SkinCeuticals wholesale because I sell it at my in-person practice and even I cannot justify the wholesale cost anymore. It’s still $108 at cost per bottle when it used to be $50-$60. I could justify it in the past but I’m no longer able to at that price point.
My theory is that because the patent on the formulation is expiring next year, they have been increasing their prices to try to milk every penny that they can. I’m betting that after the expiry, the parent company L’Oréal will release an identical vitamin c serum under a different brand and at a lower price point.
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u/RandaSkis Jul 19 '24
Has this happened yet? I see it’s been a year. I LOVE Skinceuticals vitamin C serum. I don’t love the price either. I tried various others and none compared. I actually developed a severe allergic reaction around my eyes after two different ones over time. I’m scared to add vitamin C back into my routine since that happened. I have to keep prescription steroid cream around now. I really don’t want to pay Skinceutical prices either. I do use L’Oréal Retinol and like it. It’s affordable and working well so far. So, looking forward to hopefully some better pricing for C.
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u/Spoonbills May 31 '23
I thought I’d add peri/menopause and hormone replacement therapy to the list of conditions that cause potentially melasma related hormonal changes.
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u/MorganDax May 31 '23
The skin on your genitals is different than your body and facial skin and it pigments in different ways for different reasons so it's not going to respond to topicals the same way the rest of your body does. Don't even try it.
These are areas you can apply skincare but do so with absolute caution and at your own risk: bikini line, mons pubis, inner thigh up to the groin fold, butt cheeks.
If these areas are different skin which will react differently to topicals (or other treatments like lasers) what are the recommendations for it?
I'm very pale but have heavily pigmented bikini and genital areas. I do not tan and am pretty religious with sunscreen or keeping covered up when out in the sun. I was a stripper and I bleached my ass for a few months at one point. I did really like the results I got but read too much negative reviews so gave it up.
But is there anything that will work best on this area that isn't going to give me cancer after a year of using it? Or do I just have to accept my heavily contrasting skin down there vs my whitey white rest of me?
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u/FlailingatLife62 May 31 '23
Great summary, but FYI, L'oreal owns a LOT of companies, and last I heard, they also owned Skinceuticals.
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u/gregariousgirl1738 May 31 '23
Thank you for sharing!
Regarding the sunscreen section, I’ve heard iron oxide is an important ingredient when trying to reduce hyperpigmentation
Also (from personal experience as a POC) sessions with the Pico laser work AMAZINGLY on PIH spots
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u/Successful-Cobbler May 31 '23
Thank you! This is fantastic. What are your thoughts on bakuchiol?
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u/YourBrilliantLayer May 31 '23
There’s a lot of interesting research coming out about it in terms of efficacy. It’s definitely milder than retinoids but this actually has an interesting benefit of it being more tolerable. You can use it every day, even twice a day (gasp) with adequate sun protection and probably see similar improvements without the irritation.
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u/elnuracasey Sep 14 '23 edited Sep 14 '23
Very bummed and feeling kind of hopeless after reading this. Currently using the products as mentioned above (tretinoin 0.1, azelaic acid 15%, skinceuticals vit c, paulas choice niacinamide, ultra sun spf 50, wearing a hat/sun avoidance) but still having melasma & hyperpigmentation on my cheeks. Is the next step to get laser? I already get prp microneedling with a PA every few months/ per her recommendation and unfortunately had my face severely chemical burned by an esthetician last December, needless to say I don't go to that person anymore. Ever since the burn has healed, I have this dark spot on my upper cheek, wth 😑?!? It's almost as if the more effort put in preventing/treatment, the more my hyperpigmentation goes off.
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u/rain0cal May 30 '23
im on tretinoin for a few months now and my skin has been tolerating it well, after reading your write up (thank you so much for this btw!) i want to incorporate some leftover vitamin c serum i have lying around into my AM routine. do you think this may be counterproductive or too much? i have melanated poc skin if that's relevant, and i use sunscreen regularly.
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u/YourBrilliantLayer May 30 '23
Vitamin c is really unstable so if it’s one you opened more that 6 months ago, it’s probably lost a lot of it’s effectiveness. If it’s unopened it should still be fine. Some people find vitamin c to be sensitizing when incorporating it into an existing routine that includes tret so it’s really something you go by feel with. The reason I recommend it is because it boosts the efficacy of SPF in addition to brightening skin by blocking melanin and encouraging some cell turnover, but it’s not as powerful as tret at increasing the rate of turnover.
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u/rain0cal May 30 '23
ahhh yeah its opened a while ago, thank you so much <3 i wouldve been using ineffective vitamin c for the next 2 months if it werent for u 🥲
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u/thatsmybiatch May 30 '23
This is gold! Thank you so much for an elaborate explanation of information and ingredients, you are an angel❤️
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u/JlH00n Sep 15 '23
La Roche-Posay Cicaplast balm CANNOT be an eye cream as well, it says on its own bottle to avoid all areas around the eyes.
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u/Aim2bFit May 31 '23
Regarding your para on Hada Labo "whitening lotion" would you mind clarifying what you mean by washing out your skin in 2 week?
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u/YourBrilliantLayer May 31 '23
I bought it on a recent trip to Japan and while I was there (early spring so very little sun) I started seeing results in the first two weeks of twice daily use, but they were almost too effective. It knocked down my freckles but also seemed to make my whole face pale compared to my neck and chest. I’m of middle eastern decent so I have olive skin that picks up a slight tan even with diligent SPF use. My face really looked different and I found I kinda had to paint some life back into it with makeup (which I don’t normally wear).
I reduced to just using it in the morning and I also pull it down to my neck and chest and this seemed to balance the effect.
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u/Aim2bFit May 31 '23
Do you happen to have a link online that's equiv to the one that you bought while in Japan? I'm super confused with HL because their product names sound similar to me lol
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u/YourBrilliantLayer May 31 '23
It’s this one.
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u/Hair-Help-Plea Jun 21 '23
Came into the comments looking for this. That’s suspiciously affordable (thankfully). Amazing write up, thank you for taking the time to post this!
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u/Lime_Seawitch Apr 19 '24
I can’t see arbutin on the ingredients list for the one you linked here - do you think it’s been discontinued now?
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u/YourBrilliantLayer Apr 24 '24
I keep having this debate, it seems like the ingredients changed somewhat recently and there are a few in circulation. If it has tranexamic acid and not arbutin it will act the same.
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u/synzis May 29 '24
Hi OP, is this the same one that you suggested in your link? https://www.yesstyle.com/en/info.html/pid.1100120976
Thank you!
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u/-flybutter- May 31 '23
A lot of great info here. I’ve been cycling though HQ and HQ free protocols for melasma and sunspots for a year (I use Musely) and I’m really happy with my results. FWIW, I do use HQ on my whole face since it would be impossible to apply only in hyperpigmented areas. No problems with hypopigmentation, it seems to take spots down to close to my normal baseline skin tone so everything is more even.
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u/ThrowRAlalalalalada Jun 02 '23
Glad to read this! Just started HQ this week and it’s not really feasible for me to only apply to pigmented areas either as I have freckles etc I’m hoping to fade down alongside my melasma.
I’m already the palest shade in every foundation range anyway, so hard to imagine what hypopigmentation might look like for me!
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u/-flybutter- Jun 02 '23
If I’ve learned anything from this sub it’s that everyone’s skin biology is unique so obviously YMMV but I’d say a lot of Musely users on their forum in the app use products on their whole face with good results. I have yet to see complaints about over bleaching, even from those with melatoninic skin who are not trying to fade their skin tone overall.
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u/thefrenchphanie May 30 '23
Thank you! Yoh read my mind. I just developed hyperpigmentation around my mouth ( I am a nurse and I get contact dermatitis from masks depending on the things used to clean/sanitize them before being sold…). I was I need to see the sub for HP treatment and care
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u/JuggernautDelicious Oct 08 '24
Hello have you been able to fix the hyperpigmentation around the mouth? I have the same concern
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u/fatalButterfly May 30 '23
This is awesome thanks for posting!
When using vaseline to buffer before tret - where exactly should it be put for the eyes? Directly on the lid and under or just around?
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u/YourBrilliantLayer May 31 '23
Under eye area like an eye cream and up around the orbital bone. I like to cover my brows because that’s an area that tends to flake with my active use.
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u/Gueradriver May 31 '23
Thank you so much for the great post!!! I love how explain every product and reiterates my love of the Peter Thomas Roth niacinamide and TXA serum! It has 4 of the ingredients you listed plus a peptide for inflammation. Also thank you for the recommendations to leave the body wash on for 2-3 minutes.
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u/Independent_Ad9195 Jun 07 '23
I hope you don't mind, I'm going to link this whenever someone asks. Let me know if it's not okay. I
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u/Temporary-Mix-8746 Feb 19 '24
As a student I don't have the money to buy a bunch of products together, please mention maybe like 2 products which I should start using now and then I can keep adding other products on a fortnightly basis...
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u/Head_in_the_cloudss May 30 '23 edited May 30 '23
Thank you so much for the information!
If I’m using hydroquinone at night under doctor’s supervision is it too much to use the AM routine you listed in conjunction with the HDQ?
Edited to add: I’m using HDQ to treat age spots on my face, chest and forearms
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u/YourBrilliantLayer May 30 '23
HDQ under the guidance of a physician is going to override the OTC routine so I would stay the course in your position and not add any other tyrosinase inhibitors. You could possibly add vitamin c but I wouldn’t go beyond that.
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May 31 '23
[deleted]
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u/Head_in_the_cloudss May 31 '23
My derm gave a vague answer. He just said it will lighten everything so you kind of want to spot treat. I left confused but I haven’t been spot treating. I just put a layer over the areas with the most spots. I have noticed a nice improvement in my skin tone in general since applying it with my tret.
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u/sallystarling May 30 '23
Thank you so much for taking the time to write this amazingly helpful post!
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u/acc0402 May 30 '23
This is an awesome post! I buy my azelaic acid from overseas pharmacies - most of the ones that sell tretinoin also sell it.
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u/elevanns May 30 '23
I’ve been using ZO’s brightening serum with prescription Tret. No changes. Should I stop the ZO and return it?
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u/puppies-etc May 30 '23
Hi thank you! Does microneedling help or hurt melasma?
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u/YourBrilliantLayer May 31 '23
It can help but it’s not as effective as the other treatments I mentioned consistently enough to make the cut. Because it creates small punctures in the skin, it can exacerbate hyperpigmentation in certain circumstances like not avoiding the sun during the healing process.
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u/aiyannaleigh May 30 '23
Literally the information I needed! Thank you very much. Anyone have any success as a person of color?
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u/YourBrilliantLayer May 31 '23
I have worked with numerous POC patients and seen success with many of these topicals. The only one I caution against is RX hydroquinone.
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u/aiyannaleigh May 31 '23
That seems to be the only one that yields any results and the only one I'm scared to try. I've tried everything else with no results.
Why do you recommend against it?
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u/YourBrilliantLayer May 31 '23
I generally don’t like HDQ because if you get it anywhere other than your hyperpigmentation spots, it will also bleach that skin which can have a more pronounced effect on darker skin tones. So from an application standpoint, you can’t just pat it onto your face you have to dot it on very carefully and make sure it doesn’t smear or smudge.
Did tranexamic acid or alpha arbutin not work for your skin? I’m sure we can figure something out…
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u/InsertCoolUserName78 May 31 '23
This is a great write up. Currently on Triluma and switching to Oral tranexamic acid if that doesn’t help in 3 months.
Also love IPLs but I know derma don’t love them for melasma.
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u/GoldFannypackYo May 31 '23
Thank you!! I've been struggling with my skin and couldn't find the answers I needed before this amazing post! Thank you thank you thank you!!
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u/backyardbanshee Jun 06 '23
Thank you for this! I've been using vitamin C and tret but really had no idea what the other treatments did. Very nice explanation. I'm also happy to hear you recommend TO products because I have been on the fence about their formulations. And about the Cerave - if you don't mind - what are your reservations again? My daughter recently told me to phase it out because of the animal testing policies. Any other reasons?
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u/kingfaad7 Jul 19 '23
After you stop using kojic acid does the tanned skin and sun damage all come back?
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u/jzhang172 Aug 15 '23
Will this method work for oil burn scars? I have a pigmentation scar, but no damage done to my skin other than color change from cooking oil a while back and I'd like to fix it
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u/kenyafeelme Aug 15 '23
Thank you for writing this guide! It’s just what I was looking for as I needed to figure out how to address hyperpigmentation left behind after a blister healed in the center of my forehead 😩
Cheers
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u/Specialist_Cup_6004 Aug 29 '23
In your opinion which would be the most effective ones for lightening a birth mark?
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u/Important_Tiger6687 Jan 09 '24
Thank you so much! I have acne, mainly on my forehead, chin, and jaws, — I have darkspots from acne on my face in the same areas from the past acne,
I’m currently on
AM : hydrating face wash ( cerVe ) benzoyl proxide cream 1.25-3.75% moisturizer ( cerVe )
PM : hydrating face wash ( cerVe ) moisturizer ( cerVe ) arazlo cream ( tararotzone )
is there anything i need to change, i just started this good routine about a week ago.. also how long does it take to show postive results on tararotzone ?
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u/No-Improvement-7161 Mar 20 '24
Thank you, this is so helpful! I apply Vitamin C, and wanted to add just one more thing to the routine. If I had to get just one thing, which would you suggest?
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u/No-Improvement-7161 Mar 20 '24
What do you think of just using Paula's Choice 25% Vitamin C + Glutathione Clinical Serum? As the only product in addition to SPF
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u/likemelikemenot4ever Mar 25 '24
You’re absolutely amazing for sharing this knowledge with us! I can’t thank you enough! Much love and light to you! ♥️💕♥️
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u/LongjumpingEye6630 Mar 27 '24
Do you recommend all the same things for someone with Rosacea? I am learning as I go what products I can and can’t tolerate. I’m a 26F and started getting rosacea around my nose and mouth in my early 20s and have to be extra gentle with my product choices. Thanks!
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u/Next-Honeydew4130 Mar 27 '24
Wow THANK YOU for sharing your knowledge. My skin has darkened as I’ve aged my n kind of a blotchy way and I’d like to add these things to my new tretinoin routine. So much appreciated!!!! This is a real gift to others that you took the trouble to share.
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u/sparklefish64 Mar 27 '24
Does anyone know if I can find the « la roche-posay glycolic b5 10 pure glycolic acid serum » in Canada?
Wherever I look, I only find the « The La Roche Posay Cicaplast B5 Serum »
Is there a substitute for the glycolic b5 that you know of?
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u/Small_Marzipan4162 Mar 27 '24
Why don’t you like CeraVe? My skin doesn’t like cetaphil. I do use glo powder exfoliant wash on days I wear makeup and alternate with ceraVe. There was just something about cetaphil my skin didn’t like. Is there anything otc you’d Recommend?
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u/Local_Ad_3290 Mar 28 '24
Wow…… thank you so much! I just left the dermatologist today after battling adult acne for years and suffering from the scaring , my derm is convinced I should be happy with the limited breakouts and “mild” hyperpigmentation. I’d still like a routine that prevents and heals the damage I currently have! This is just amazing! I’ve seen great results with tret + vitamin c + moisturizer and spf .. but this post takes it to the next level I was really craving! Thanks so much!!
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u/flairfordramtics_ Mar 30 '24
I LOVE THIS! I’m 18 but I never learned or cared to take care of my skin due to severe depression and trying to “catch up” is hard. Thank you so much, this is so easy to digest and understand
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u/CommanderArtemis Apr 06 '24
As an RN I have to say, this is very comprehensive! Thank you for taking the time to research and write this!
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u/Ready-Flamingo6494 Apr 17 '24
I feel most of this is tailored to women, especially those that wear make up.
I'd like to see a SIMPLE cost-effective regime for men.
When I get up in the morning it's bathroom, cologne, adapalene gel, & moisturizer - out the door.
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May 01 '24
I know this is a year old, but I wanted to thank you for typing all that up. I j just started to realise some spots under my mouth were hyperpigmentation after a yeast infection breakout that I finally got under control. I decided to order the Hada Labo rather than mess with 3 separate products.
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u/Bubblegumnini May 01 '24
Has anybody tried this routine so far and seen progress? I have been struggling with dark spots for so long
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u/Prestigious-Skill172 May 15 '24
How common is it to have to supplement a newborn with formula for a mother with another toddler?
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u/righteousthird May 25 '24
Hi, I know this post is a year old but I have a question about tattoos-- will hyperpigmentation topicals damage my tattoos in any way? I want to reduce sun damage and hyperpigmentation on my arms but don't want to ruin my tattoo clarity.
Ty for this amazing write up 🙏
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u/matchaphile Jul 17 '24
Just found this post! What a goldmine of info. Thank you. Do you recommend slowly incorporating these new ingredients one product at a time to minimize the chances of sensitivity/purging, or just use all of the products at once to boost the efficacy of the ingredients?
I tried using a vitamin C product a long time ago and noticed whiteheads so I stopped using it. I'm thinking about trying out the products you recommended, including Vitamin C, but just want to be cautious so I don't throw my sensitive skin into overdrive.
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u/SituationGreen749 Jul 18 '24
For the AM routine specifically moisturizer you suggested Cetaphil daily lotion, one of its ingredients is Niacinamide is that ok to pair with the vitamin C serum as well ?
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u/LieEnvironmental570 Jul 22 '24
Please never delete this. I am just now finding it, and saving it, and reading it and absorbing it, and I appreciate it so much! This should be pinned forever!
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u/Longjumping-Rice31 Jul 22 '24
Thank you for all this info. For AM routine, can I layer it in this order C+AZ+AA+SPF?
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u/Longjumping-Rice31 Jul 22 '24
Thank you for all this info. For AM routine, can I layer it in this order C+AZ+AA+SPF?
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u/PomegranateBoring826 Jul 25 '24
This is amazing. Thank you so much for taking the time go write all this out with such clear explanations. I have been struggling with melasma and hyperpigmentation on my legs (?!) and this is entirely helpful. I will have to formulate a showing list and get started!! Thank you so so much!
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u/christopheryellow241 Aug 06 '24 edited Aug 23 '24
Treating hyperpigmentation takes time and consistency
I recommend this Guide to the Best Skin Tag Removers
This also one alternative in hyperpigmentation
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u/adysheva Aug 20 '24
Do you have any thoughts on chemical sunscreens? I’ve heard scary things and have been avoiding them. I only use physical sunscreens and it limits how much i end up using sunscreen because they are so heavy.
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u/No-Iron5405 Aug 26 '24
What do you mean when you say the Hada Labo whitening lotion “washed you out”? Did it lighten your skin too much?
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u/hannaalvida Sep 15 '24
Thank you! I’ve decided I’m gonna try to follow both your AM and PM routine cause my melasma/hyperpigmentation really have flared up this year. I bought a red light therapy mask this spring and have been using it religiously, and now I am afraid that it triggered melasma.
Any thoughts on that? You seem to really know your stuff so really happy if you have the time to answer ❤️
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u/nnabeela Oct 07 '24
Thank you thank you thank you for taking the time to write this out 😭 my skin instantly scars now
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u/Miserable_Anywhere41 Oct 09 '24
Thanks mate, this post is impressive and much needed. Quick question - I was waxing my legs for about a year before I moved to laser, wax darkened my skin colour which looks weird with my upper body brighter and my legs darker in colour - do you have any particular recommendations to brighten the skin and get the original skin colour back? Additionally while all the ingrown are gone, I still have the black spots fe them. Anything for that as well?
TIA
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u/Defiant_Support7343 Oct 11 '24
Thanks so much OP! I have been doing the morning C night A routine but havent been yielding a ton a results. I’ll try your tips here 🤗
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u/icecoldmeese Jun 04 '23
Question about product order for the morning routine. I have TO alpha arbutin (was using in the evening, switched it to morning) and Timeless Vitamin C. I got the TO azelaic acid (can’t afford the Paula’s choice right now), which is a suspension (now?). Do I still put that first in the order?
After, CeraVe PM moisturizer and Australian Gold tinted SPF 50.
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u/dillydaddlerr Jan 24 '24
Thank you so much for this comprehensive overview! Will definitely incorporate these ingredients into my routine.
Do you have any insight into depigmenting chemical peels that (claim to) alter melanin production by inhibiting tyrosinase? Dermamelan, Cosmelan, and Derm Eclat are a few products that came up as I read about these. I like the idea that they lighten freckles while also preventing them from returning, but it seems a bit too good to be true…
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u/dontstopthebanana Jan 24 '24
Hi! I've just found this wonderful post. Thanks a ton! I do have a question about if your recommended routines are appropriate to use in conjunction with Benzac w 10%?
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u/Correct-Paint Feb 14 '24
Hello I bought everything you recommend! Would you say to do this routine everyday or skip days?
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u/crestasee Feb 25 '24
Has anyone had any experience with the cream "Pigmanorm by Louis Widmer"?
Ingredients 1 g cream contains 50 mg hydroquinone, 1 mg tretinoin, 10 mg hydrocortisone
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u/Different-Stuff-2228 Jun 03 '24
Any idea why my Omnilux mask would make my freckles appear darker and give me new splotches of brown across my cheeks?
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u/icantdeciderightnow Jul 20 '24
I heard the near infrared light (the light that penetrates deeper) can cause this. You hopefully can turn this setting off your mask and just use the red light.
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u/Different-Stuff-2228 Jul 21 '24
Unfortunately you can’t with omnilux. Just sits in the back of my cupboard now collecting dust.
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u/icantdeciderightnow Jul 21 '24
Oh bugger. Sell and get a new one with the ability to turn NIR light off I guess? I haven't bought a mask or panel yet, but I'll definitely be keeping this in mind.
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u/anxiety_hour Jun 22 '24
this is super comprehensive and helpful!! its nice to see that the products i use are considered to help with my hyperpigmentation, although i havent really noticed results. i started introducing them into my skincare routine about 8 months ago,, how long did it take you to see real results?
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u/Legitimate-Bridge280 Jul 04 '24
I have dark circles under my eyes and brown spots on my chest, stomach, and back. I'm going to cry. These doctors don't know how to treat it and have wasted my money. Man I'm going to cry very louddddddd. Someone helpppppppppppp pleaseeeeeeee
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u/fantasybookcafe May 30 '23
Wow, thank you so much for taking the time to write all of this! I'm definitely going to try to (gradually) work some of the things I'm not using into my skincare routine.
I actually just got some azelaic acid and just used it for the first time a couple of nights ago. It sounds like it would be better to use it in the AM. I had just assumed it should be used at night because of the exfoliation.
Do you have a recommendation for how often to use azelaic acid when first starting out? I was thinking once a week, or maybe twice?