Pigmentation tends to occur more frequently in darker and oilier skin types, so the below is targeted towards this skin type in particular. You may need to change it up a little if you have drier skin, but it can be tailored exactly to your skin type to get the maximum results while targeting the dryness too.
There are three basic steps to a skincare routine to target pigmentation:
- Exfoliate – you want to help clear off the existing pigmented skin cells, and a liquid or cream exfoliator is the best way of doing this. A cream can be more concentrated, and I tend to advise this for 6-12 weeks (or sometimes longer) to help shift existing pigmentation.
- Stimulate new skin cells – as you age, your skin cell production slows down (“just like the rest of me?!” I hear you say, yes, and sorry, it’s not actually my fault, but sorry to be the one to break it to you), and this is where some form of retinol or vitamin A comes in. As pigmented skin is usually found in slightly older skin, a stronger prescription strength retinoid can be worth it.
- Something to stop the new skin cells turning out just like the old ones! You may have some very annoying pigmentation in situ for years…but obviously, due to skin cell renewal and lifespan, they are not the exact same skin cells – they are just following in the footsteps of those that have gone before them. So the key to preventing this cycle is something that steps in and blocks this. Hydroquinoine (HQ) is one of the most reliable pigment blockers, particularly for darker skin types. Arbutin, liquorice extract, mulberry extract, and a whole host of anti-oxidants can definitely help, but if I have a patient with particularly problematic pigmentation, I reach straight for the HQ. It is a prescription ingredient when in sufficient quantities in most countries, overuse can cause other skin issues, and it is toxic in very high concentrations, so you do have to be cautious. I am currently researching (read: using myself as a test dummy as I read up on new things!) some antioxidants that have been reported to be as efficient, so watch this space.
- And sorry, there is a fourth one, the most VIP: WEAR SUNSCREEN, and a hat.
- Cleansers: Obagi 360 Exfoliating Cleanser, Dermalogica Special Cleansing Gel, Alumier MD Purifying Gel Cleanser, Kiehl’s Ultrafacial Cleanser. Please note, cleansing only happen after you remove your makeup with some sort of oil based cleanser. Generally when you are using the active ingredients below, a wash of some sort helps make sure you get sufficient penetration of these active ingredients in the later steps of your skincare routine (even if you always used a cream cleanser before – it can take a bit of trial and error to get it 100% right).
- Toner: My homemade ACV toner is always my first choice, but if you need a bit extra decongestion (or you skin appears to be having an extended acne crisis) always Pore Therapy. I can’t find one to beat it, or even come close.
- Exfoliant: Nip and Fab pads ( the regular ones, not the extreme) are handy if you’re not sensitive to glycolic acid, as is the Pixi Glow Tonic (although I find the Pixi tends to irritate skin more than N&F) Bright and Clear is gentle enough for most skins, although it can cause irritation like the previous one, just nothing as often.. Obagi Exfoderm Forte and the Obagi Exfoderm (more suitable for dry skin) both pack a serious punch but you might want to come see me first to make sure you’re using it correctly.
- Hydrating spray: any of the ones from the pharmacy, and you might even have some lying around the house. Super to add this in when using a retinol/vitamin A.
- AM: HQ or some form of pigment blocker – my favourite above all is this one from Obagi, pricey, but worth it. Fantastic for older, drier skins too due to the oil-boosting effect of vitamin C. Oiler skins have to be careful (this is what I use myself). You have to come see me to get your hands on this one, or look at other options if we’ve got a major pigment disaster.
- PM: retinol or tretinoin. Retinol is available over the counter. This one from La Roche-Posay is not bad as a starter (and the only one available from a regulary pharmacy that I recommend), but you might want to look at this one if you’re past the 30 mark. Tretinoin is what I prescribe for a course of treatment when someone is also using the prescription strength HQ etc.
- Moisturiser AM: I choose either a hydrating sunscreen, like Sheer Hydration, and skip the moisturiser altogether after the serum step, or I use a moisturiser that has a proper amount of sunscreen in it like Hydrafactor. Sunscreen is ESSENTIAL to prevent pigmentation. You may need a stronger moisturiser than you are used to when you start using something like Exfoderm and a proper retinol, even if you have oily skin to begin with.
- Moisturiser PM: If I’m using a lot of active ingredients like retinol, and my skin has dried out a bit, I’ll reach for Hydrate, as it’s one of the only heavier ones that doesn’t block my pores, but whatever one work for you. Cetaphil night is a great budget option.
I’ve struggled with pigmentation and marks after acne (post-inflammatory hyperpigmentation or PIH) and my Obagi skincare journey began with their C-Rx system. This made a noticeable difference, but a year later I went on the full course of Nu-Derm, and to say it transformed my skin is an under statement. Within a month of using it, the compliments just started flooding in. I do not use this system all the time, it is not what I consider my basic skincare routine – I used it as a treatment for 3 months, and only went back to it this month for a little short term booster (about a year after I finished it). These systems are not for everyone, and if you are lucky enough to get a decent response from adding just one or two prescription strength products into your routine that is fantastic. However, there will be some people with more resistant pigmentation, and that is where you might have to look at a full system to really get the skin you want.
Whatever your skincare concern, there is a way to improve it, you just might need some help from me and some prescription products.