Monthly Archives: June 2013

What can I do about my Dark spots? Help for hyperpigmentation.

I know I have shared with you all about the fact that I am a Skin Care specialist for an amazing local dermatologist.  I have been in the medical field for over 25 years.  I have talked to you all about moisturizers, and acne, and today I want to talk some about another issues that are very problematic.  DARK SPOTS!!!!!

Dark spots, or hyperpigmentation (the correct medical term) is a skin problem that can affect men and women of all ages, and can be very embarrassing and make people self conscious. It affects how we feel about the way we look.  Acne is troublesome also, but that can usually be cleared up rather quickly with the correct medication.  Dark spots do not clear up as quickly, and sometimes it can take a combination of preventative measures, corrective products and procedures to keep our skin looking the way we want it to look.  I am going to talk today about Melasma, sun damage, and acne induced dark spots.
I understand the difficulties of uneven skin tone and dark areas on your skin very well.  Not only do 95% of my patients come see me to correct uneven skin tone, but I also suffer from an uneven skin tone problem.  I am an olive complected caucasian, and I have a skin condition called Melasma.  That is where I want to start today.

Melasma is a skin condition that affects women more than men, and is caused by our hormones, (great, one more thing to blame our hormones on).  It affects all skin tones (caucasian, african american, asian and latin) people.  It can sometimes be easier to see on women with a lighter skin tone (skin tone 1-2) because of the contrast between their regular skin tone and the melasma.  The skin is usually “splotchy”.  The dark areas do not have even borders, and can even appear like “spatters” of dark spots on the face.  As if someone took a paintbrush and dipped in a darker skin tone and then spattered your face with the darker color.

Melasma on my forehead

Melasma on my forehead

Those are a few ways it can look on different skin tones.  The skin can look as if you have a mustache on the upper lip.  It is also referred to as the “mask of pregnancy”.  That is because often when women are pregnant and their hormones are all over the place, melasma shows up.  I can tell you though that you DO NOT have to be pregnant to get melasma.

Sun damaged skin can look very similar to Melasma, however, it usually shows up looking more like dark brown circles on the face that have very clear borders, unlike melasma. Sun damage spots are more visible in skin tones that are lighter such as caucasian, asian and latin.  African American and Arabic skin, while it can also get sun damage will have less than lighter skin tones because of the darker skin tones, which offer more protection from sun damage than lighter skin tones.

Then there are the dreaded spots from acne.  Patients will call me and say they have “acne scarring”, or “Blemishes” or simply “dark spots” from acne.  These discolorations can occur on the face, neck, chest, shoulders and back.  Anywhere there has been an acne bump.  Acne causes redness and inflammation many times, and in skin of color inflammation or redness commonly leads to a dark spot.  The dark spots will be worse if you “pick” or “squeeze” your acne bumps.

Dark spots caused by acne.

Dark spots caused by acne.

Okay, so I have told you about a few different kinds of hyperpigmentation.  So now you want to know what you can do to make it GO AWAY!!  Right?  okay, I will talk about that now.

So what can you do to clear up your skin???  Well, the first step is to prevention.  For melasma and sun damage that means 1) SPF 30 (at least) sunscreen on your face EVERY day that you are outside.  2) Try not to be in direct sunlight without covering your face with a hat, visor, umbrella, etc.  I wear a visor ALL summer long.  We went to the beach for our weekly vacation and my body was protected with sunscreen.  My face was protected with a big floppy hat.  If my arms and legs are brown and my face is not I am totally okay with that.  I battle melasma all the time, so I protect my face from the sun as much as possible.  HATS are your best friend.

For acne the best prevention is an appointment with a good dermatologist to get medication that will prevent you form continuing to get bumps.  I talk more about acne and treatments here.  Truly the key with acne is the proper medication to keep the bumps from coming in the first place.  Second, if you do get bumps, DO NOT PICK, SQUEEZE or otherwise mess with them.  That will help tremendously to avoid dark spots!

The next step is products.  There are even prescriptions you can use to help with lightening dark spots.  Specifically the medication is “Hydroquinone”.  It has 4% hydroquinone which is a skin lightener in it, however it can be VERY expensive (most of the time at least $60.00 to sometimes over $100.00).  For comparison, a very nice over the counter product you can use to lighten dark spots is Ambi, or Porcelana fading cream.  They have 2% hydroquinone, so they are less potent than a prescription, but are more affordable.

However, my FAVORITE product that I have had LOTS of success with (I use it myself and LOVE it),  is Genius Ultra Pads by Arbonne. I have sold this product to many patients, and every single one of them has seen improvement using it. (I use it and it works for me also) As a matter of fact, most of them say it works better than the prescription Hydroquinone.  It is used in the evening and is botanically based which is why I love it so much.  It has ingredients in there that are botanical: phytinol (plant retinol), mandelic acid, grain alcohol, and other botanical ingredients.  Those botanics are natural lighteners and it works beautifully, and smells great!!

genius-before-nd-after

genius

Step three is procedures that are done in the doctor’s office or a spa.  Procedures administered in a doctor’s office are generally stronger than the ones at a spa, but not always.  In our office we administer Theraplex and Vitalize peels as well as microdermabrasions (which are for people who cannot tolerate a peel).  While a peel will usually work more quickly on dark spots, not everyone can tolerate a peel, and if a peel is used on a sensitive person the skin can be burned and permanently damaged.  Lower strength Glycolic peels can be purchased online as well, and used at home, but I would caution anyone who is considering doing that to make sure your skin can tolerate a peel.  Truly the best way to know is to make an appointment with a skin care specialist, dermatologist, etc who has been trained to know what questions to ask, and understands the complexities of skin.  Everyone is different and because there is the potential for long term or even permanent damage to ones skin, proceeding with care is important!  The peels we administer are: Theraplex 20% and 30% salicylic acid peels  and Vitalize peels which are Salicylic acid, lactic acid, resorcinol, and retinoic acid.  Obviously the Vitalize peels are stronger, however I have used them on people of all skin tones.

We also administer microdermabrasions for dark spots on people who cannot tolerate chemical peels.  They sometimes take a bit longer to see results, but over time they work well also.  We use the smart peel microdermabrasion system, but there are others that work well also.

Some physicians have also touted laser as the best way to remove dark spots from acne, sun damage and melasma.  I have to admit I have never used a laser on a patient but I can tell you while I have heard very good things about them, please do your research. Lasers can be costly, and it can take many treatments.  In addition laser is not as effective on darker skin tones.  It is best suited for lighter Caucasian skin.  I as a darker toned Caucasian would need to be cautious also.

There are many other treatments, products and peel systems out there.  The best thing I can say is if you have questions do your research, find a good Dermatologist and make an appointment. If they don’t answer your questions to your satisfaction, find another one.  Doctors are vying for business and are affected by the recession just as we all are.  Therefore they WANT your business and should work to keep your business.  And if you live in the Hampton Roads area and have questions, let me know, I give FREE consultations and work on Mon – Sat.   If you don’t live near me, come visit!!!  🙂

How my family is different than yours!

family004

I am a 47 year old woman who has been a member of many families.  First, there is the family I was born into.  I am the second child in a family with three children.  I am the only girl with two brothers.  I lived with my two brothers and my mother and father until I was 18 years old.  I grew up in the 70’s and 80’s which was a time that was different than growing up now.  We didn’t have all of the technology that kids have these days.  I think of it as a simpler time, but to be honest that may be because I was a kid and didn’t have the responsibilities I have as an adult.  I don’t know if my parents would call it simpler.  My family was far from perfect.  We had our struggles, and our good times.  We had dysfunction and we had function.  But over all when I look back on my childhood, I remember being cared for and not worrying too much.  We had food on the table, and were taken to the doctor and dentist regularly.  My father always had a job and we always had a house to live in. My parents did the best they could, and frankly I think they did a good job.

Then there was my Navy family.  When I was 18 I joined the Navy and my coworkers became my “family”.  We all shared a similar vision, and frame of reference.  I think in many cases people in the military bond so well because “teamwork” is talked about all the time, and we are in such close quarters, both living and working. If you are a young person in the military you probably live with your shipmates (or fellow soldiers as the case may be), and so a certain camaraderie and sense of “family” is established.

So now I am a grown up and have a family of my own.  However, my family is different than many other families and I am going to tell you why:

joy rocks

I believe that kids should get good grades.  Getting an education gives you options, as I always tell my kids, and unfortunately for my 16 year old, I talk about his grades and his education ad nauseum.

I have always expected my kids to get a job when they turn 16.  I am relentless about them looking for work.  I make them keep a list of the places they have applied and the dates, so they know when to contact the managers and check up on their applications.  I have done this for the 20 year old, the 18 year old and most recently the 16 year old.  These days it is not as easy for a young person to get a job and follow up is very important.  The squeaky wheel get the grease, and the kid who goes back week after week to “check in” with the manager of a place of employment gets the job.  (The 20 year old, 18 year old and 16 year old have jobs by the way)

My “adult” graduated from high school children pay rent if they live in my house after graduation.  Now before you get upset about that, you need to know that it is a very small amount, and I actually put it aside and give it back to them when they move out so they can use it to buy things they need for their own apartment.  I believe that a young adult needs to understand responsibility and staying in our pocket forever will not do that for them.

A big way our family is different than most is that the teenagers in my household do NOT get a cell phone unless they can pay their bill themselves.  We do have them on our phone plan so their bill is only $50.00 per month, but since they earn an allowance, they use it to pay their bill first, and then use the rest for their own enjoyment.  We feel as though a phone is a luxury not a necessity, and luxuries need to be funded by the person who wants said luxury.  If they blow their money and can’t pay the phone bill, I suspend the phone line, so it can’t be used until it can be paid for.  Isn’t that what will happen to me if I don’t pay my bills?  Why not teach them the responsibility of paying bills while they are teenagers?

There are also many ways my family is JUST LIKE millions of other families.  We fight with each other, but are fiercely loyal to each other.  We joke around and have fun with each other.  We love each other and can’t stand each other alternately.  (Some days more than others).  Sometimes our feelings for each other change on an hourly, even moment by moment basis.

So, you can see that just like millions of families around the world, our family is just like some families and very different from other families!  The differences and the way we parent makes a significant impact on the kind of adults we are raising, and we really want more than anything else to raise adults who are kind, caring, responsible, compassionate, productive members of society.

babyblues

Photo courtesy of: www.babyblues.com

Oh, and I suppose I forgot to mention that one other small way our family is different than others.  We are a two mom household.  And believe it or not that makes NO difference at all in the way our family functions, or how we relate to each other.  It doesn’t change the fact that our kids play sports on school teams, that one son is a Boy Scout, that we like to be together, and we need space from each other.  We fight and love and laugh together.  Having a family with same gendered parents does not make our family function any differently than any other family, and it isn’t better or worse.

It just is what it is, and we are quite happy with it!