Correction, part 2: Tone and Texture

This entire series is about simplifying and breaking down the skin care aisle(s). Because there are so many products promising to fix so many things, we’re on our second post about correction. We’ve reviewed the best new and classic anti-aging products that focus on fine lines, but here we’ll talk about those that correct tone and texture...or spots and roughness: Let’s get that glow. 

The sun's rays can lead to cellular changes involved in the formation of skin cancer as well as visible pigmentation changes. This can show up in freckles, larger dark spots (lentigos), and melasma when combined with hormonal changes. 

How do we prevent this?  

SPF! I think you guys know by now that sunscreen is or should be our best friend and most essential part of skincare. Wearing a daily SPF can help prevent damage to our elastin and collagen (our skin's support system) from harmful UV rays, in addition to preventing increased melanin production (the endpoint being dark spots and blotchiness).

So say we’re beyond prevention. The damage is done.…What to do to visibly reduce this dark spots and overall dullness?

Here’s what to look for in your labels or in the shpeel from your skin-care provider, whomever they may be: 

Hydroquinone: potent topical lightening treatment available over-the-counter in a low strength formulation or prescribed in higher strength products that inhibits a key point in the pathway that leads to increased melanin production. 

• Compounded formulations can be stronger (a higher percentage than those available over the counter) or compounded with other medications for an overall more effective anti-aging fighting cream.  
• Ambi Fade Cream: Available over-the-counter, for sensitive, oily or normal skin, containing 2% hydroqiuninone (for reference, the compounded formulations range from 4-12%). 

Azelaic acid: known to help with dyspigmentation, especially the darkness that occurs after an insult like a blemish or cyst, more common in patients with darker skin tones. It is not as irritating as other skin-lightening agents so can be worked into a skin care routine easily to make it more effective. 

• The Ordinary Azelaic acid suspension: Available over-the-counter in a 10% strength. With a low price point and shipped to your door, it is an easy place to start. 
• Finacea: Prescription strength 15% Azelaic acid available in a wonderful foam vehicle that alone is moisturizing and beneficial to the skin. 

Other Antioxidants: Yes, this sounds familiar. We talked about them in the anti-aging post. Because free radicals that cause DNA damage resulting in aging, fine lines, dullness, annndddd...dark spots...can be lessen by protecting the skin with antioxidants. 

Ingredients targeting pigment tend to work better in combination with products that exfoliate and/or accelerate skin turn-over. In my mind, the former is digging up the pigment and the latter is sweeping it away. This can be a retinoid (Retinols, Tretinoin, Altreeno, Adapalene…over the counter or prescription) or an alpha- or beta-hydroxy acid (salicylic or glycolic acid).  

• Skin ceuticals glycolic renew overnight: This definitely tingles a good bit when applied, but the glow is noticeable the morning after. Great for patients who cannot tolerate a retinoid. And safe in pregnancy.
• Chemical peels: In office treatments for a more powerful punch (and more peeling..duh) for faster results. Ranging from lunch-time peels which will have you glowing by dinner time, to those requiring you to keep working from home for a few days.

Remember, these products should be incorporated into a routine that works with your skin and with your goals. If you view your dark spots as decorations, leave them alone and focus on wrinkles! Or redness. Or whatever it is that drives your crazy. The good thing about having so many options for correcting things, is that your skin care routine is totally customizable.

Author

Patricia O'Connor, MD Board Certified Dermatologist