NS: Hi! I have some dark discoloration above my upper lip. It's not a mustache because the hair is bleached. What causes this and how can I get rid of it ASAP? Thanks!
CG: This is a great and very common question. The pigmentation in this area, as well as the cheeks and sometimes the forehead, is highly responsive to hormone fluctuations. Any hormonal shift (on/off birth control, pregnancies, phase-of-life changes), when combined with UV exposure, can result in dark areas. Typically this is more noticeable in the summer time.
CG: The irritation from using a hair bleaching product may also be contributing to what you are seeing, so in addition to the skin info I'm going to give you, please know that tweezing, threading, or even shaving (yes, I know, crazy right?) would be the safest ways to address that hair from a pigment perspective... safer than bleach or (heaven forbid) chemical depilation, and safer than waxing because you'll need to be using corrective skincare that contraindicates waxing.
NS: Wow, ok. I can do that.
CG: Now, in addition to hormones and skin irritation, pigment becomes an issue because even with fastidious use of the best available SPF products, there's always some % of rays that penetrate, and skin that is susceptible displays pigment very easily. We have many options for home skincare products with ingredients that help "turn down the volume" on the pigment producing cells. They can be used all over or by zone.
NS: I have been at the beach...sunscreen of course.
CG: No problem. The Skin Takeover starts now. Once the skin has been prepared by lowering the output of pigment, most of my clients will do a series of peels to initially lighten the dark areas faster than home care alone, and then strategically do a few peels throughout the year to keep pigment under control.
CG: The pigment suppressing home skincare is a prerequisite for any peels that are strong enough to help with pigmentation, because they ensure even results. Usually for Caucasian skin, 2-3 weeks on pigment inhibitors in advance of the first peel is plenty. Darker skintones and those with more equatorial ethnic heritage (Asian, Latin American, etc.) require longer prep time as these skin tones are more responsive with pigment.
NS: Ok should I come in for the prereq product? Is it just one product or a regime?
CG: Yes, a pretreatment pigment suppression routine consists of, at a minimum, an effective SPF (we'll switch you over to a good mineral one), a retinoid (skincare vitamin in the Vitamin A family that helps cells turn over faster), as well as a pigment suppressor (ingredients known as tyrosinase inhibitors which downregulate the amount of melanin pigment that's being produced by the melanocytes, or pigment cells). One in every 40 cells in the basal layer of our skin is a melanocyte, and how much pigment it makes and squirts out into the surrounding cells depends on genetics, hormones, sun exposure, and irritation to the skin. For this reason it's also very important that we examine the rest of your home routine to make sure there are no irritants or photosensitizers that would interfere with the efficacy of your home care or peels. Can you tell me what you're currently using on your skin?
CG: No problem. The Skin Takeover starts now. Once the skin has been prepared by lowering the output of pigment, most of my clients will do a series of peels to initially lighten the dark areas faster than home care alone, and then strategically do a few peels throughout the year to keep pigment under control.
CG: The pigment suppressing home skincare is a prerequisite for any peels that are strong enough to help with pigmentation, because they ensure even results. Usually for Caucasian skin, 2-3 weeks on pigment inhibitors in advance of the first peel is plenty. Darker skintones and those with more equatorial ethnic heritage (Asian, Latin American, etc.) require longer prep time as these skin tones are more responsive with pigment.
NS: Ok should I come in for the prereq product? Is it just one product or a regime?
CG: Yes, a pretreatment pigment suppression routine consists of, at a minimum, an effective SPF (we'll switch you over to a good mineral one), a retinoid (skincare vitamin in the Vitamin A family that helps cells turn over faster), as well as a pigment suppressor (ingredients known as tyrosinase inhibitors which downregulate the amount of melanin pigment that's being produced by the melanocytes, or pigment cells). One in every 40 cells in the basal layer of our skin is a melanocyte, and how much pigment it makes and squirts out into the surrounding cells depends on genetics, hormones, sun exposure, and irritation to the skin. For this reason it's also very important that we examine the rest of your home routine to make sure there are no irritants or photosensitizers that would interfere with the efficacy of your home care or peels. Can you tell me what you're currently using on your skin?
NS: Peter Thomas Roth Glycolic Acid 3% Facial Wash (w/ Clairsonic), Garnier Moisture Rescue Refresh Gel Cream, Mario Badescu Seaweed Night Cream
CG: Based on a quick scan of the ingredient lists, the cleanser is fine when properly diluted (no aromatic irritants or photosenzitizing ingredients) but when you run out we'll switch you to something with more Glycolic acid to accelerate your results. The gel cream concerns me because it is mainly composed of a solvent alcohol, which means it may not be adequately hydrating your skin, and it's also buffered rather high on the list with sodium hydroxide (lye) which helps hold gel formulations together, but is not great for the pH of your skin (I avoid alkaline substances because the skin's pH should be between 4.5 and 5.5 for maximum barrier function). Since it also contains a photosensitizing aromatic ingredient, linalool, it may be contributing to your skin's pigment reaction, so let's plan to get you onto a more suitable light moisturizer. The night cream is also free of irritants so it's safe to continue using, but it doesn't contain any impressive anti-aging ingredients, so when you finish that jar, I'll be happy to show you some antioxidant and peptide options capable of further supporting your skin.
CG: Now for the big question, since you didn't mention one - what are you using for daily SPF?
NS: In my makeup but I'm inside all day. If I'm outside at all, 30 SPF.
CG: Do you use your makeup for full coverage, or just where you need it? I know this is nit-picky, but when skin is sensitive to pigment, even those short bursts of UV like driving, walking to and from car, etc., can make a big difference.
NS: Yes full coverage, but I can start using the heavier stuff if it helps.
CG: Yes, the way it works is that once the pigment-producing cells (melanocytes) in a given area have already been sensitized to overproduce pigment, they will be reactive to the slightest aggravation thereafter. For example, even leaving the bleach on too long when you do your upper lip could irritate the skin and cause some pigment to kick out (your skin's only way of protecting itself from perceived trauma). So the sunscreen in makeup isn't usually sufficient to prevent UV-induced pigment changes.
NS: So heavier SPF even for limited bursts of sun? I can do that. Do you have a recommendation? A lot of sunscreens irritate my skin.
CG: Yes, we want a daily application of a Zinc Oxide based SPF under makeup daily. This ingredient is important as it protects against the broadest spectrum AND functions as a skin-soothing ingredient, whereas other SPF active ingredients can be irritants and risk generating heat in the skin.
NS: Great. I'll be in tomorrow. Thanks!
CG: I look forward to it! As always, feel free to bring any skincare products you are using if you have any questions about what order/whether a product might be helping or hurting. I'm happy to check out ingredients for you :)
CG: Now for the big question, since you didn't mention one - what are you using for daily SPF?
NS: In my makeup but I'm inside all day. If I'm outside at all, 30 SPF.
CG: Do you use your makeup for full coverage, or just where you need it? I know this is nit-picky, but when skin is sensitive to pigment, even those short bursts of UV like driving, walking to and from car, etc., can make a big difference.
NS: Yes full coverage, but I can start using the heavier stuff if it helps.
CG: Yes, the way it works is that once the pigment-producing cells (melanocytes) in a given area have already been sensitized to overproduce pigment, they will be reactive to the slightest aggravation thereafter. For example, even leaving the bleach on too long when you do your upper lip could irritate the skin and cause some pigment to kick out (your skin's only way of protecting itself from perceived trauma). So the sunscreen in makeup isn't usually sufficient to prevent UV-induced pigment changes.
NS: So heavier SPF even for limited bursts of sun? I can do that. Do you have a recommendation? A lot of sunscreens irritate my skin.
CG: Yes, we want a daily application of a Zinc Oxide based SPF under makeup daily. This ingredient is important as it protects against the broadest spectrum AND functions as a skin-soothing ingredient, whereas other SPF active ingredients can be irritants and risk generating heat in the skin.
NS: Great. I'll be in tomorrow. Thanks!
CG: I look forward to it! As always, feel free to bring any skincare products you are using if you have any questions about what order/whether a product might be helping or hurting. I'm happy to check out ingredients for you :)
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