How to Get Rid of Dark Spots and Uneven Skin Tone

Airdate: 2/7/12

Dark spots, age spots, liver spots, sun spots, pregnancy mask, melasma- it doesn't matter what you call them; these discolorations are downright frustrating. Find out what products to use to get rid dark spots and even out your skin tone.

Desiree Stordahl: Hello and welcome to "Be Beautifully Informed" with the Paula's Choice Research Team. You have myself, Desiree Stordahl, Bryan Barron, and Daynah Burnett, tonight as your beauty experts. And we are going to be talking all things dark spots - age spots; liver spots; sun spots; pregnancy masks - Melasma; hyper-pigmentation. It doesn't matter what you call it; the solutions are all the same, and we are going to be talking about how to even out your skin tone and get rid of those dark spots.
00:00:33 We want to invite you to call in at 347-426-3783. And calls that we take will be getting free Paula's Choice products that are going to help out your beauty solutions and skincare needs. But before we delve into that, Daynah, you had an interesting experience with Avon when you were researching for our latest edition of "Don't Go to the Cosmetics Counter Without Me."
00:00:56 Can you share your experience with that?
Daynah Burnett: Absolutely. I did. It is interesting because I think a lot of women turn to foundation and complexion products to help even out their skin tone. And I was doing some research with some new foundations that Avon has on the market, and as we typically do I purchased light shades and dark shades. And what I noticed is that all of the dark shades didn't include SPF on their SPF-rated foundations.
00:01:26 And when I asked Avon about this, I called them today, they told me that they are not including SPF on their ethnic skin-toned complexion products. And that is a travesty.
Desiree Stordahl: Yeah. It is not as if they don't need sunscreen, too. Everyone needs sunscreen. So that is very unfortunate that they are taking that stance.
Daynah Burnett: Well, it is extra unfortunate because it is not clearly marked really on their website, and these products are being sold as though they include SPF, and low and behold you get the shade that you are looking for and it doesn't.
00:02:00 So, it is kind of a double lose. And it was a really disappointing move on Avon's part.
Desiree Stordahl: And, Bryan, you also kind of had an interesting story about SPF, particularly in regards to tonight's topic about dark spots. What did you find?
Bryan Barron: Yeah. We get all of the big fashion magazines here. And it was either in Elle or Vogue. And one of the reporters, her assignment was to gather up a bunch of the latest skin lightening/skin brightening products, and she decided to test them on different parts of her body.
00:02:36 She was described as having some sun damage, some freckles from too much time in the sun. She also went to a dermatologist and talked about various treatment options there, but in the process she was trying all of these new products. And, of course, everything worked to a certain degree. She really didn't have anything bad to say about the products, even though those that we have reviewed on Beautypedia on her list aren't necessarily all roses.
00:03:01 But what got to me about this piece was that it wasn't until the very last sentence of the article that one of the most critical aspects of skin lightening, or for that matter preventing the brown or the dark spots in the first place, was mentioned, and that is sunscreen. It was almost an afterthought. And it just pisses me off when I read pieces like that that don't put enough emphasis on the other products that you need to use. It is never as easy as just using a simple skin lightening product.
Desiree Stordahl: And that brings us to our topic tonight. It is how to get rid of dark spots and uneven skin tone. And primarily where you get these dark spots from are from sun damage, and hormonal issues, typically around pregnancy, sometimes when people start a new birth control pill it can trigger it as well.
00:03:56 But essentially it is an excess of melanin production. And there are various ways of treating it. The first and best way, Bryan, what is that?
Bryan Barron: Well, the longstanding favorite is hydroquinone. It has been around for over 50 years. It has a very good track record in terms of efficacy and also safety. We discussed a bit of the controversy for that ingredient last week. I'm not going to go into that again, but suffice it to say, as a starting point: not everyone will respond to hydroquinone.
00:04:31 It is available in over the counter strength, up to 2%. And 2% is really what you want to start with. If you happen to find a product that only has say, 1%, you can just ignore that, because 2% is the minimum that the research has shown if you are going to have an effect, if you are going to see improvement, you want at least 2%. You also want to make sure that whatever hydroquinone product that you are considering is applied at least once a day.
00:04:58 You don't want to buy any hydroquinone product that is packaged in a jar or a clear container. Hydroquinone is an unstable ingredient in the presence of light and oxygen. It will oxidize and turn brown, at which point it really starts to lose its effectiveness, not to mention becomes aesthetically unappealing. Who wants to put a thick brown product or a brown gel on their face if the brown is what they are trying to remove?
00:05:26 But you need to be consistent with hydroquinone use. You should start seeing results in about 8 to 12 weeks of consistent use. If you don't, and if you have been diligent every day, and we mean every day, even if the sun isn't shining, even if it is in the middle of winter, even if you live some place that only gets an hour or two of daylight, you have to protect your skin from the sunlight. Really it is about protecting skin from UV light which is present even when you can't see the sun. It is present even on a cloudy day.
00:05:57 Those UVA rays, which are bombarding our skin, even at the crack of dawn - if you can see daylight, UVA radiation is present. It comes through windows. It is pretty insidious. And the UVA portion of the sun's rays is what has the biggest influence on the pigment producing cells in your skin. That is what gets them excited. That is what starts out a chain reaction within the skin, the result being uneven skin tone, brown spots, brown discolorations.
00:06:29 So hydroquinone is the gold standard. If you are finding that a 2% amount does not work for you, you can try a 4% strength which is available via prescription. And then alternatives do exist, because as I mentioned, not everyone is going to respond favorably to hydroquinone, even the prescription form. So if you have patient, if you have been diligent, been using the hydroquinone product for at least two to three months, and you are just not seeing any - or you are seeing very little improvement - and you swear on your mother's grave that you have been good about sun protection, there are other alternatives that you can consider.
00:07:07 And Desiree is going to tell you about those.
Desiree Stordahl: Exactly. And one thing I just noticed on our website is that our skin lightener with hydroquinone, we have two of them, we have the Resist Remarkable Skin Lightening Lotion with 7% AHA, and the Resist Clearly Remarkable Skin Lightening Gel with 2% BHA. The first one I talked about with the AHA is actually on sale right now. So just throwing that out there as a tip to our listeners. I didn't realize that until just right now myself.
00:07:36 But for options beyond hydroquinone, even though that is the most well-research topical skin lightener, and it tends to produce the most consistent results, there are other alternatives, and those include niacinamide, licorice extract, acetyl glucosamine, azelaic acid. And for azelaic acid to be effective as a skin lightener, it needs to be in a concentration of about 15% to 20%, which is going to be a prescription-only concentration. The name for that actually is Azelaic. There is a product out there in that percentage of azelaic acid.
00:08:12 There are also other prescription options such as tretinoin and tretinoin combined with mequinol. And the name for that is actually Solage. That is the product that you would find. Again, prescription-only. And then other stabilized forms of vitamin C which include ascorbyl acid, ascorbic acid, and magnesium ascorbyl phosphate.
00:08:38 There are also some natural alternatives, and these skin lightening agents actually break down into hydroquinone when they are absorbed into the skin, which explains why they have a positive lightening effect. There is [matter] extract, bearberry extract, mulberry and white mulberry, paper mulberry, arbutin. So there are other alternatives out there.
00:09:00 They may not work as well as hydroquinone, but if hydroquinone didn't work for you, these would absolutely be something to try. And, also, you can look on Beautypedia for our recommendations of skin lighteners without hydroquinone.
Bryan Barron: Yeah. Our list of best skin lightening products on Beautypedia offers those we found with and without hydroquinone that stand the best chance of helping your discolorations.
00:09:26 One of the things that can really help with any potential skin lightening ingredient is to use them in tandem with, or look for products where the skin lightening active is combined with an alpha hydroxy acid, or beta hydroxy acid exfoliant. When Paula was formulating the two skin lightening products for Paula's Choice, she wanted to do that, so we have our skin lightening lotion that contains 2% hydroquinone and 7% glycolic acid which is the most well-researched alpha hydroxy acid.
00:10:01 And then our Clearly Remarkable Skin Lightening Gel contains 2% hydroquinone as well as 2% salicylic acid. So, the exfoliation process with an AHA or BHA product is going to increase skin cell turnover. It is going to help those dead layers of skin cells that have built up after sun damage come off as they normally would, because with sun damage and with time that process gets stunted. It goes into a state of disrepair and it just doesn't happen as normally as it should.
00:10:34 So, without question you are going to see more efficacy if you combine one of the skin lightening ingredients we talked about with an exfoliant product. So that, combined with sun protection - one of the discussions we had recently with Paula was we actually got into a bit of a debate. I don't know if you remember this, Desiree, but we were talking about the new Resist Hand Cream with SPF 30, and Paula wanted to say that it helps fade dark spots.
00:11:08 And I was arguing that I didn't quite understand how it could do that because it doesn't contain ingredients such as hydroquinone. It contains a smattering of plant extracts that can help brighten the skin. Do you remember that discussion, Desiree?
Desiree Stordahl: Yeah, I do. And her point being that the sun protection is really the fading effect.
Bryan Barron: Yes. So that is what I wasn't getting that finally made sense was that the very act of protecting your skin from sun exposure allows the skin to start healing itself. And so when you are doing that, in conjunction with using the lightening ingredients, and you are using the exfoliating ingredients, you are treating your skin gently, you are going to see that much more improvement.
Desiree Stordahl: So, Bryan, fill us in on the laser and light treatments that you can use.
Bryan Barron: I'm not going to go into the specific ones because the truth of the matter is that almost any laser or light emitting device with the exception of the LED type devices, whether in a professional setting or the kind you use at home, but a true laser or a light emitting device such as Intense Pulse Light, they will all have some impact on brown spots and discolorations.
00:12:29 The wavelengths of these lasers are naturally attracted to the color of melanin. And it is one of the reasons why it is definitely a struggle if you are a woman of color, of African American descent, Indian, Polynesian - you just have a naturally darker skin color. You can certainly still find yourself dealing with brown spots, sometimes from something as simple as a skin injury, just melanin in darker skin, because there is such a higher concentration of it, and that gives you the added advantage of having more built in sun protection.
00:13:09 But on the downside is something as simple as just skin trauma, like bumping your arm or leg into something that would form a bruise, you could also be left with some lasting dark spots because melanin is involved in the inflammatory response. Another reason why women of color tend to have lingering dark marks from acne, especially if they have been using drying, irritating products, is that melanin gets mixed in with that inflammatory process.
00:13:40 In somebody with a lighter skin tone, that inflammatory process becomes a bit more vascular, so it involves the circulatory system. It is why on somebody with a fair skin tone like me, I am going to see pink or red marks from where a blemish used to be, but a woman of color would see a darker surrounding skin rather than red or pink.
00:14:04 So, the lasers and the light emitting devices, the problem with using them on darker skin tones is that they cannot differentiate between the melanin that is naturally present in your skin and evenly distributed, and the concentrated spot of melanin that you want lightened. So, there is a limited range for women of color of laser and light treatments.
00:14:29 The best thing to do is to find a dermatologist that specializes in pigment issues. They are out there, especially in larger cities. And there are some solutions that you can consider. Over and above laser and the light devices, you could also consider a series of chemical peels with alpha or beta hydroxy acid, or even something a bit more potent like trichloroacetic acid which is also known as TCA. Those are options as well for most skin colors.
00:15:00 The TCA, not so much for the darker skin, because it tends to go a little bit too deep. And, again, because melanin is involved in the inflammation response, you could end up with excess pigmentation, or a loss of pigment that you don't want. So, for the most part, lasers, IPL treatments would be a good place to start. From there you can move on to what I call the bigger guns, such as the Q-switched Ruby laser, or Fraxel treatments.
00:15:32 There are a lot of them out there. And any competent cosmetic dermatologist that is running laser procedures is going to know the right lasers to use for pigmentation issues.
Desiree Stordahl: And I have heard Paula mention before that for women of color to visit a dermatologist that has a similar skin tone to theirs, because obviously that dermatologist is probably going to have a bit better knowledge and experience, who has worked with their skin tone and can definitely hone in and tune into those things that that person may need.
Bryan Barron: Yes.
00:16:07 The one thing that everyone who is batting uneven skin tone from sun damage and dark spots especially need to keep in mind is that pigmentation, whether it is Melasma as Desiree said, or dark spots, whatever you want to call it, pigmentation issues - they can be tricky. And they can be very difficult to get rid of completely. It can be done, but it often takes a multi-pronged approach.
00:16:33 So, rather than just using the skin lightener and sunscreen, you may need to combine that with an exfoliant as we talked about. You may need to include a product with retinol. Retinol is an ingredient we haven't mentioned yet, but there is a great deal of research showing how retinol, both over the counter which is retinol, and then prescription from such as tretinoin, a brand name is Renova, those can help.
00:16:58 They work to interrupt what is known as the pigment pathway. And, again, that is a complex series of events that occurs within the skin that leads to the pigmentation spots that we see and want to get rid of. And then, of course, just to close out the topic, and we will get right into callers, sunscreen use. I know, I know, I know, I know it is boring. I know we have said it 1,000 times. I know that there is really no way to make sun protection sound sexy or appealing.
00:17:30 It is sort of like brushing your teeth and taking the trash out. We do these things not because we want to but because we have to. What you need to keep in mind is that the very issues that you are struggling with, with pigment right now, could have been prevented by and large if we had just been better about using sunscreen every day. And I'm in the same boat. I know that a lot of you are thinking, "Yeah, but we didn't know about this when I was younger, or, "Yeah, but when I was a kid nobody used sunscreen."
00:18:03 Absolutely true. Sunscreen use is a relatively recent practice. But the truth of the matter is, as much as we know about that, not enough of us are applying it as often as we should and we are not using as much as we should. So, especially for those of you who are listening who live in sunny climates - I know we have a lot of Paula's Choice customers in Texas, Arizona, Florida, California.
00:18:28 They will even email us and say, well, I have got "California skin," or, "Well, I have lived in Florida my whole life, so of course I have sun damage." Absolutely. You need to be especially vigilant. And if you are struggling with pigment disorders, Paula feels strongly that the mineral actives of titanium dioxide and zinc oxide are a superior option for preventing discolorations from recurring. You absolutely want that if you are going to go through the trouble of treating them, especially if you are going to go through the defense that treating these pigmented lesions with lasers can involve.
00:19:05 It just makes sense to protect your investment. So look for the mineral sunscreens. If you have a darker skin tone and you find that those mineral sunscreens tend to go on and look white and pasty, which nobody wants that look - there are options out there that have a natural tint that you can put over a naturally darker skin tone without turning that strange lavender/purplish color.
00:19:29 You will find those products on Beautypedia. And, Daynah, let's start taking some calls.
Daynah Burnett: We have so many callers tonight. I'm really excited to get started. I want to start with Eantha in California. We were just talking about "Californian skin," and she has a question about products with hydroquinone. Eantha, are you there?
Eantha: I am. Hi all.
Bryan Barron: Hello.
Eantha: My question is this. I have used hydroquinone, both 2% as well as 4%, over all periods of time, so to speak, over years.
00:20:03 And I was just wondering, after I have used it for a while, it seems to stop, or slow down. I was just wondering if efficacy has been affected perhaps because of simply opening the tube, or is there a shelf-life issue with it, or what?
Bryan Barron: Yes. That is a very good question. There absolutely is a shelf-life with hydroquinone. Even in the best packaging, you want to make sure that you are using it up probably within 6 to 12 months. So within a year.
00:20:38 And then depending on the formulation, and this is tricky because it is really impossible for a consumer, unless they are schooled in cosmetics chemistry, to be able to look at an ingredient list and say, "Yeah, that will be a stable product," or, "That hydroquinone product is formulated to make sure that the hydroquinone is going to remain potent for longer."
00:21:00 There are things that you can watch out for, such as the jar or the clear packaging which are definitely red flags, but otherwise it is best to just go by the use within 6 to 12 months of opening. If you still have some left after that period, honestly, if it were me I would toss it and start new, especially if you were seeing a drop off in the efficacy.
Eantha: Right.
00:21:29 And that is something that I have noticed from time to time. Yes, it works well in the beginning once you get going with it, and then, yeah, I have noticed a drop off. Definitely. Definitely.
Bryan Barron: Eantha, you can also try taking a break from it. And just maybe give about 4 to 6 weeks. Once you have seen some results, continue using an AHA or BHA exfoliant, but otherwise move away from the hydroquinone and then revisit it and see what happens.
00:21:57 I don't have any hard research to back that up. It is more anecdotal from things I have heard over the years. So, don't take this as a "must," just take it as a tip, something that you can personally experiment with, and see if that helps as well.
Eantha: Okay, good. Thank you. I will definitely take your advice.
Bryan Barron: All right. And we are going to go ahead and send you our latest and greatest Paula's Choice product. We are going to let you try our Resist Intensive Wrinkle Repair Retinol Serum.
Eantha: Great. Thank you.
Bryan Barron: You are welcome.
00:22:30 So you can give that a try. You can put it on after the skin lightening product.
Eantha: Okay. Will do. Thank you very much.
Bryan Barron: Thank you. Who is up next, Daynah?
Daynah Burnett: All right. So, this is a great question. This is Cynthia in California. Cynthia, you are on the air.
Cynthia: Hi. My question is about sunscreen. You were saying, I had heard that mineral sunscreen was better for protecting your skin when you already have discoloration. The concern I have is what if it is too heavy or if it is not, like, I tend to get some clogged pores. So that is not really the preferential sunscreen for my skin type, but it is preferential for Melasma.
Bryan Barron: Yeah.
00:23:14 There are a couple of workarounds for that. One is that you can use the "heavier" mineral sunscreen only on those areas where discoloration is a concern. And then you can use a lighter weight sunscreen/daytime moisturizer elsewhere. I know it is a bit of a pain to juggle two products that essentially have the same purpose, but that is one potential workaround.
00:23:38 The other is to experiment with - there are several products out there that combine one of the synthetic sunscreen actives like Octinoxate, or Octocrylene, Oxybenzone, with one of the mineral actives such as titanium or zinc oxide. The advantage to that is that you are going to get the benefit of both, you are going to get the - I hate to say "extra protection" but you are going to get the, I will just say it, the extra protection that zinc oxide would provide, but because it is mixed with that synthetic sunscreen active, the texture generally speaking should be a bit lighter.
Daynah Burnett: Bryan, that combination you mentioned, the Octinoxate and the titanium dioxide, I see that a lot in foundations. Would that work as well?
Bryan Barron: Absolutely.
00:24:29 Yes. That is another option, Cynthia. I wouldn't say - if Melasma is a concern, I definitely would advocate using a foundation with sunscreen as a means to not only give you enhanced sun protection but to help even your skin tone. But don't rely on the foundation with sunscreen alone, because chances are you are not going to be you are not going to be applying enough or you probably won't want to apply enough of it to get the stated level of protection. Does that make sense?
Cynthia: Yes, it does. So use a sunscreen and then get extra protection with the foundation. That is a great idea.
Bryan Barron: Yeah.
00:25:04 And then one of the products that I'm going to - I will send you one of our Paula's Choice products to try. And it is going to sound a bit strange because it is our Ultimate Anti-Aging Hand Cream, with SPF 30. And Paula, I'm not exactly sure how this came about, but at one point Paula decided to try it on her face. It may have been when she was traveling, and she forgot her facial sunscreen and figured, "Well, this will work."
00:25:33 And there is nothing in the product that can't be used on the face, but Paula really likes it. It has got a nice moisturizing, but not greasy, sort of a satin matte finish. And it has SPF 30 with just the titanium dioxide. So you can try that. And then another product that you can consider that I personally like for normal-to-oily skin prone to breakouts is from SkinCeuticals. And it is the SkinCeuticals Physical Fusion.
00:26:03 I think it is called Physical Fusion UV Defense SPF 50. And it has a slight tint to it, and it has a really nice lightweight texture and silky finish, while providing a very high amount of mineral based sun protection.
Cynthia: Great.
Bryan Barron: So those are some products you can try. We will send you the Ultimate Anti-Aging Hand Cream. And I want you to give our new retinol serum a try as well, even if you just use that in the areas where you are struggling with Melasma. That along with sun protection, and a good skin lightening product, I think you will see a nice difference in your discoloration.
Cynthia: Okay, great. Thank you.
Bryan Barron: Thanks, Cynthia.
Daynah Burnett: All right.
00:26:46 Next up we have...we had...okay. She is no longer on the line. Sorry. Leslie, from Illinois. She's gone. So we are going to talk to Shane in Ohio who is also struggling with Melasma. Shane, you are on the air.
Shane: Hi, thanks for taking my call.
00:27:09 I was diagnosed with Melasma and I have used Renova in the past. And now I use Tri-Luma which is off the market. And I have also had...
Bryan Barron: Isn't that sad?
Shane: Yes, it is. And I don't know why. I can't get an answer.
Bryan Barron: You know, I can't either. I have asked around. I have asked the dermatologist I see. And for those who don't know, Tri-Luma was an amazing prescription product that combined 4% hydroquinone with tretinoin, which is the active ingredient in Retin-A, as well as a low dose topical steroid which made the combination of the hydroquinone and the tretinoin, two very active ingredients, usable for a lot of people. And Tri-Luma was made by Galderma, the same company that makes the Cetaphil line of products.
00:27:59 And, yeah. I'm with you there Shane. I wish I could get a straight answer as to why that was not available, or if it is coming back. Most dermatologists now when you ask for 4% hydroquinone will give you a generic 4% hydroquinone product which just - you are getting the active ingredient you want, but those products just don't have a very nice texture.
Shane: Uh-huh.
Bryan Barron: Have you tried those?
Shane: No, I haven't.
00:28:28 She offered me something called like "Blanc," or I am not sure. It is something like the word white, like Blanc, something like that. Do you know that prescription? I don't know the exact name, if I have the exact name right, because I didn't take it because I thought I had some of this left, so I am still using it, even though it is getting a little past the date, but you know.
Bryan Barron: Yeah, I'm not aware. There are several brand name prescription hydroquinone products. SkinMedica makes one. I think it is called EqiQuin that has 4% hydroquinone.
00:29:04 That would be one there. That has a bit more of an elegant texture. And it is actually a pretty good alternative for those who used Tri-Luma. Although, because it doesn't contain the tretinoin, if you are having good luck with that, now you will need to use two prescription products to deal with the issue. But, hey, if that is what works, that is what you have to do.
Shane: Right.
Bryan Barron: So Shane, what is your current struggle with Melasma.
Shane: I have had Microdermabrasion. And I still have the patches. Now they change from brown to pinkish, and my dermatologist, she won't do laser on the spot because she keeps saying, "Oh, just keep plugging away."
00:29:40 So I don't know if I would end up with more damage or something worse looking from the laser, but she just said she doesn't recommend doing it which I am kind of surprised why she won't do it.
Bryan Barron: What is your natural skin color?
Shane: Pretty fair.
Bryan Barron: That is a bit shocking.
Shane: I can still see them. They have turned from brown, but they are still pink.
00:30:02 And even with the concealer - I was listening to your last week's show, I didn't get to listen to all of it, but trying to cover them up, and I can still see it through my makeup and concealer.
Bryan Barron: Huh. So, what you are seeing now in the Melasma areas - isn't really tan or café au lait anymore, it is pink?
Shane: Yes. Yes.
Bryan Barron: Okay, so, I wonder if your dermatologist may have been thinking that you are not going to see much improvement in those areas. Because if the lasers that she uses in her practice are specifically targeted to deal with melanin, what you are seeing now, what the pink is, that is not melanin. It is likely the remnants of post-inflammatory hyper-pigmentation.
00:30:50 So what you can try - now you are using sunscreen regularly, right?
Shane: Yes.
Bryan Barron: Okay. So we have a product that I will have Daynah send you that is in our Resist line. It is out Anti-Aging Clear Skin Hydrator. And that contains an interesting mix of niacinamide, a B vitamin ingredient, along with a form of stabilized vitamin C, and some other goodies. And we formulated that specifically to not only give anti-aging ingredients to our customers who are struggling with wrinkles and breakouts, but also to help fade red marks from acne.
00:31:26 And I know that the pink and the red that you are seeing isn't from acne per se, but these ingredients that I mentioned help to reduce post-inflammatory hyper-pigmentation, which I think is what you are dealing with now. So I would like you to try this product for maybe two to three weeks and see if you start noticing an improvement.
Shane: Okay.
Bryan Barron: And, you are still using - I don't know if I should send you their retinol serum because you are using the prescription Tri-Luma as well. Although, you don't necessarily need to keep using the Tri-Luma over that area if it is just post-inflammatory hyper-pigmentation.
00:32:10 You may actually want to set that aside, or use it if you have other brown spots, like on your arms or your hand. You could start using it there, you know, if you are worried about it going bad before you might need it again for your face.
Shane: Okay
Bryan Barron: So, let's do that. I think if you are not seeing any signs of tan-to-brown discolorations in those areas, I don't necessarily see the reason to keep using Tri-Luma, because it is not going to really have much effect over the lingering pinkness or redness.
00:32:41 But, a product with retinol may well help further fade that along. So, we will send you our new retinol serum. You can give that combination a try and let us know how you are doing.
Daynah Burnett: Great. So, speaking of mixing retinol, we have got Wanda from New Jersey, and she has a question about mixing a retinoid with hydroquinone. Wanda, you are on the air.
Wanda: Yes, I am. Thanks for taking my call.
Bryan Barron: Hi Wanda.
Wanda: Hi, Bryan.
00:33:12 I'm African American and occasionally I will get dark spots on my cheek, just because of a pimple or something. And I use Retin-A Micro in the evening. And so my question is: Would it be okay to dot hydroquinone over that to help see brown spots fade faster? Or would it be better to alternate one night with the Retin-A Micro, and then the next night do the hydroquinone?
00:33:42 Because you mentioned that Paula's products are mixed with either an AHA or a BHA, but you didn't mention that any of her products are mixed with the retinoid.
Bryan Barron: Right. First, let's distinguish - retinoid is a general term for several different vitamin A ingredients. And you have the over the counter forms, such as retinol, retinyl palmitate, retinaldehyde. Those are all the forms of vitamin A that are permissible for use in cosmetics.
Wanda: Okay.
Bryan Barron: And then you have your prescription retinoids such as tretinoin, adapalene, which is the active ingredient in Differin, which is mostly used for acne. And then tazarotene, which is the active ingredient in Tazorac. That is used for acne and wrinkles.
00:34:32 Retin-A Micro that you are using contains tretinoin. So, to answer your question, I don't want to get too off track here, you can do either of what you mentioned. You can dot on the hydroquinone product over the Retin-A Micro, or you can alternate by applying every other night. What it is going to come down to is how your skin responds.
Wanda: Okay. I just didn't want to irritate it too much because I know both of them can be a little irritating. So, I was a little apprehensive about dotting the hydroquinone over the Retin-A.
Bryan Barron: Right.
00:35:14 And that is why my advice to you is to go ahead and give it a try, but pay close attention to how your skin responds. If you notice any signs of irritation, which would probably manifest as dry patches, flakiness, the area may tingle or feel like a slight, almost a sunburn like sensation, then I would say to step back and separate the application.
00:35:41 But chemically speaking, there is no reason that those two ingredients can't be joined. As we were just talking about the Tri-Luma product, that formerly combined hydroquinone with the prescription retinoid in one cream product. But you are absolutely right - hydroquinone and prescription vitamin A ingredients, there is always going to be somewhat of a tolerability issue.
00:36:05 And any time you are taking two active ingredients and combining them, the tolerability issue becomes more of an issue. And it is not going to be something that affects everyone. There are some people that can use all manner of ingredients mixed together that would send another person's skin into a tailspin, which is why you really just have to experiment and see what happens.
00:36:29 And, Wanda, don't forget the sunscreen.
Wanda: Okay.
Bryan Barron: Are you using one daily?
Wanda: I use sunscreen in the morning before I put on my foundation. But to be honest, I don't put it over my entire face. I sort of dot it, if you will; so I will dot it around my eyes and near my temple, because it just feels so heavy. Like I feel like I have too much on my face, but I do use it around the eyes. I use something called [Alleria]; I think it is an SPF 30. Alleria.
00:37:04 It's something I get from the dermatologist.
Bryan Barron: Okay. So, we need to have you experiment with other products, though. If you want to keep using the Alleria around your eyes, then go for it, but ideally you need to get something on your entire face as well. Even though you are of African American descent, you have a darker skin color naturally, which means that you have some built in sun protection. You have got that extra melanin to help prevent some amount of damage.
00:37:40 Not all. I mean, women of color absolutely have sun damage issues, and they absolutely are not immune to skin cancer. It is just that people with lighter skin colors from about an Asian skin tone on up are definitely more at risk.
Wanda: Okay.
Bryan Barron: So, my concern though Wanda is that by not putting the sunscreen over your entire face is that when these post-inflammatory hyper-pigmentation happens, or if you eventually do start seeing some sun spots from cumulative sun damage, then what are going to do?
00:38:18 It's like, let's - it is better to be proactive than to just kind of -
Wanda: I will be chasing the dots around, right? Chasing them around my face.
Bryan Barron: Exactly. Yes, Wanda, you are reading my mind. We do have some...I'm going to send you our Skin Balancing Daily Mattifying Lotion with SPF 15 from Paula's Choice.
00:38:42 I want you to give that a try because it has a really light lotion texture. And I want you to see how you like the feel of that on your skin. You can send us an email. You can email custserv@paulaschoice.com. Contact our customer service department and let us know how you are doing, and they can put us in touch. And I can give you some other recommendations if, for whatever reason, you are not happy with that one.
Daynah Burnett: All right.
00:39:14 So Bryan, I have got some great news. Leslie from Illinois that dropped off the call, he found us on Facebook. And Desiree is going to read you his question. Desiree, are you there?
Desiree Stordahl: Yes, I am. So the question is: I had flat beauty marks lasered a few years ago, and I couldn't completely eliminate them from my face because my dermatologist compared them to a natural tattoo on the face.
00:39:36 I haven't had any treatments in two years and want to know if there are any new procedures that may eliminate them?
Bryan Barron: You know, I saw this question on the switchboard, and I was hoping to get Leslie on air, because what I think he meant by beauty marks is moles. And moles are - moles can be brought out by sun exposure, but most of the moles that the average adult has are hereditary.
00:40:05 They are part of your genetic makeup. You may not have had them as a kid, but through your genetic tendencies they start popping out as an adult. Moles, they are almost impossible to remove completely with a laser. And the main reason for that is that if you were to look at a cross-section of skin, so that you were seeing the upper most layers all the way down to the dermis and the subcutaneous fat, the pigment that feeds moles goes pretty deep.
00:40:39 And it pretty much goes beyond the reach of what lasers can do. And speaking from personal experience, I have had several moles removed over the years for various reasons, typically because they look suspicious, and then they are biopsied. And that is something that I advise anyone to talk to the dermatologist about.
00:41:01 If you see a mole that is changing color, changing texture, its border has become irregular, or especially if it itches and scabs over and bleeds, and just seems like a cut that never really heals and keeps coming back - Please go see your dermatologist and have that checked out.
Daynah Burnett: Bryan, I'm sorry to interrupt you. I've got Leslie here on the air. Would you like to talk with him?
Bryan Barron: Sure.
Daynah Burnett: Okay, here he is. Leslie, you are on the air.
Leslie: Hi Bryan.
Bryan Barron: Hi.
Leslie: Hi, this is me, Leslie. First, I should clear up. You guys think I'm a guy. That is my father. He recently passed away, so he is my profile pic on Facebook.
Desiree Stordahl: Ah.
Bryan Barron: Oh, okay.
Leslie: Yeah, hi. So I have been listening to what you said.
00:41:49 I tried to have these suckers lasered. I must have done it probably seven or eight times over the course of a couple of years, and they lightened up, but I didn't completely get them. And then the doctor one time went in there, what do you call it, the deeper wavelength, to try to get them. And then I kind of got a scab that one time, and kind of a mark, and the mark faded, but then after that I never tried going in at that deeper wavelength again.
00:42:18 Never completely got them out.
Bryan Barron: Yeah. So we are talking about moles, aren't we?
Leslie: Yeah, just flat moles. Yes. I had some that were kind of raised, and I was able to get those sliced off and cauterized, but these are just little small, flat ones that I just don't like.
Bryan Barron: Yep. Leslie, I know what you mean. And lasers can help, but they can only do so much because of the depth of the pigmentation. So, what most people see who get moles treated with lasers, and again, we are talking about the flat moles, not the raised kind - those, as Leslie mentioned, do need to be surgically removed or they essentially will shave off the top portion of it and then see how it heals.
00:43:01 And then if you want the rest of the mole removed, you can have that done later. But, at best you will get some lightening of the spot, but in order to eliminate it completely, it literally needs to be cut out of the skin.
Leslie: They are not that big. They are not ugly. I'm not going to cut that out. I basically just refuse.
Bryan Barron: Yeah, it is basically a tradeoff. Because depending on, A, how deep the mole is, how much they have to cut, and then, B, how well your skin heals.
00:43:38 You could essentially be trading one thing you don't like for another. And so you have to, in the big, grand scheme of things, are a few moles that you were able to successfully lighten with a laser really that bad, or would you rather have potentially indented or white scars where the mole used to be?
Leslie: Yeah, that was his point.
00:44:00 Because I saw both a dermatologist, a laser doctor, and a plastic surgeon. And, you know, they did what they could, but they just said, you know, deal with it. They are not even ugly. I don't even barely see them. I was just wondering if there was anything new yet. But if there isn't I can live with it, I guess.
Bryan Barron: Yep. Let's leave it at that, Leslie. Let's have you live with it. And then we are going to send you our new retinol serum which you can try on your face and neck and see how that improves your skin. And, who do we have on the line next, Daynah?
Daynah Burnett: We have another Illinois call. We have Nicole. Nicole, you are on the air.
Nicole: Hi.
Bryan Barron: Hi Nicole.
00:44:39 Illinois is being represented tonight.
Nicole: Yeah it is.
Bryan Barron: What's on your mind, Nicole?
Nicole: My question is just that I have some old acne scars, and I have seen commercials for products that claim to get rid of them, and I was just wondering if there was anything that really worked?
Bryan Barron: What are you talking...tell me how you would describe your acne scars?
Nicole: You know, I didn't have really bad acne, so they are nothing too bad.
00:45:08 Just like little spots that, I don't know, I guess they are kind of -
Desiree Stordahl: Are they pinkish or reddish marks?
Nicole: Kind of pinkish/reddish. Yeah, like left over. I would just like to get my skin to the point, I guess, where I can wear just a tinted moisturizer or a foundation, or not wearing foundation.
Bryan Barron: Desiree, any suggestions? Go ahead.
Desiree Stordahl: Yeah.
00:45:34 Have you tried our Resist Anti-Aging Clear Skin Hydrator?
Nicole: No, I have not.
Desiree Stordahl: That sounds like it would be a perfect for her, Bryan.
Bryan Barron: Yes. I was going to recommend that as well, Nicole. What you are dealing with, in general speak people refer to them as acne scars. Technically they are not a scar. They are post-inflammatory hyper-pigmentation. So, what happens when we get these breakouts is that the immune response to that area is fairly swift and strong.
00:46:05 And with that extra immune response, the greater circulation, the enhanced white blood cells that are brought to that area, without getting too technical, it can leave a bit of a mess in its wake. So, it is trying to heal the blemish for you. It is recognizing some of the bacteria that is causing the blemish as foreign and is trying to kill it on its own.
00:46:31 It often doesn't work that well, and you are left with a pink or red mark that can last, depending on how bad it is, they can last up to a year. And they just take a long time to fade. And even six months feels like forever when you are looking at it in the mirror every day, right?
Nicole: Yeah, oh yeah.
Bryan Barron: And I absolutely understand the desire to just want to put on tinted moisturizer and be done with it , and get on with your day. But then you try that and you think, "Well, that is not giving me any sort of coverage, and now, oh my gosh, now I need all of this coverage."
00:47:07 So the Resist Anti-Aging Clear Skin Hydrator contains ingredients designed to help fade those marks faster. And are you using either an AHA or a BHA exfoliant?
Nicole: Yeah. I have both the Peter Thomas Roth, the BHA, the exfoliant, and the gel wash.
Bryan Barron: Okay. Let me get you started on one of our BHA exfoliants.
00:47:30 I don't think Peter Thomas Roth has any that are within the correct pH range to be effective.
Nicole: Yeah. I saw on the website that they are really not that good, but they are like $35 a bottle, so I didn't want to like...
Bryan Barron: So you didn't want to waste it.
Nicole: Yeah.
Bryan Barron: Is your skin more normal-to-oily or normal-to-dry?
Nicole: Oily.
Bryan Barron: Do you prefer a gel or a liquid?
Nicole: I guess a gel. That is what I have been using a lot lately.
Bryan Barron: Okay.
00:48:04 And so let's do this. Let's get you started with - we will send the Resist Anti-Aging Clear Skin Hydrator and then before that we want you to put on our Skin Perfecting 1% BHA gel. You can just apply a thin layer of that, once or twice daily, all over your face. The directions are right on the bottle, so you don't have to write all of this down right now. And you can check our website at PaulasChoice.com and read more about this product.
00:48:32 But I think between those two products that will really help to fade those marks faster. And then you are doing something to protect your skin from sun damage, right?
Nicole: Yes, I am.
Bryan Barron: Okay, good. Because unprotected exposure to sunlight or to UV light in general is going to cause those marks to last even longer. Because one of the sneaky little things that unprotected sun exposure does is it starts to damage cells in our skin that are part of its immune system.
00:49:06 When those cells become damaged, and I am talking about them becoming damaged, even if you don't see any sign of a sunburn, or you are not getting tan, just the presence of UV light can be enough to impair these cells. And then what happens is your skin has to struggle and loses its ability to heal as quickly and as efficiently as it normally would. So, once again, I know it is like a record that just keeps skipping over the same song - sun protection, sun protection is absolutely essential, whether your discoloration is from an acne breakout, or whether it is from sun damage or contraceptives, whatever it may be.
00:49:47 Without the sunscreen you are fighting a losing battle.
Daynah Burnett: Bryan, I think your advice for her is spot on. I actually struggled with the red marks from acne, and our BHA, you are right, it took a few months, but at this point a tinted moisturizer, and I am golden. So, great advice. Moving onto Andrea in California. Andrea, you are on the air.
Andrea: Hi, thanks for taking my call.
Bryan Barron: Hi Andrea.
Andrea: I have some - can you hear me?
Daynah Burnett: Yes, we can hear you.
Andrea: Sorry about that.
00:50:29 I have some kind of dark spots from acne that had popped up. I think it is related to what you are talking to with the previous caller with the post-inflammatory hyper-pigmentation. I use a standard Lubriderm, but my wedding is coming up, and I am trying on a lot of backless gowns. I was wondering if there is anything I can do to kind of fade those spots, any products or ingredients that I could really look for over the counter that maybe might give me a miracle.
Bryan Barron: When is your wedding?
Andrea: It's about three months, in April.
Bryan Barron: Okay.
00:51:08 You've got time. So, you are concerned about these marks on your back?
Andrea: Yes.
Bryan Barron: Okay. All right. There are absolutely some things that you can do. We are going to send you - one of the top things you can do to speed the healing of these marks is to start using a beta hydroxy acid exfoliant.
Andrea: Okay.
Bryan Barron: So, you are going to have to enlist the help of a friend, or your loving fiancé, to help you reach certain areas I'm sure, because applying products to the back just is impossible to do thoroughly all by yourself.
00:51:49 So, let's - we will get you our Skin Perfecting 2% BHA lotion.
Andrea: Oh great.
Bryan Barron: And that is designed for the face, but it absolutely can be used from the neck down. If you have any dryness back in that area, it will help with that. And then other than that, you can try the Resist Anti-Aging Clear Skin Hydrator, followed to that, but now you are being good about sunscreen or when you are outside your back isn't typically exposed, correct?
Andrea: Correct.
Bryan Barron: Okay.
00:52:30 Are you still dealing with breakouts on the back?
Andrea: I think possibly the stress from work and wedding planning, I'm seeing more of that, especially with the winter dry skin, kind of the bumpiness as well.
Bryan Barron: Oh, you are going to love the 2% BHA lotion. It is going to help with that, too.
Andrea: Okay.
Bryan Barron: The other consideration is what you are using to wash with. Are you using like a creamy body wash? Are you using a bar cleanser?
Andrea: Just a bar soap right now.
Bryan Barron: Okay, stop that.
00:53:07 From your next shower on, or at least until you can find a suitable product. Bar soaps - and I suspect what is happening is that the combination of the bar soaps and then the Lubriderm not being a very advanced formula isn't really doing your skin any favors.
Bryan Barron: The ingredients that keep bar soaps and bar cleansers solid in their bar form, not only do they not rinse easily from the skin, but they can be a source of dryness and irritation, even if they say that they are moisturizing.
00:53:43 The biggest issue in a situation like yours is the residue that those bar cleansers can leave behind, because what happens is that with subsequent use that residue kind of keeps building up and building up, very much like soap scum in your shower, where you get to the point where you are like, okay, I have to clean this.
00:54:00 It is my least favorite chore, but I have to do it. The same thing happens to your skin because that residue is never completely rinsed off. And then what happens is that the dead skin cells that would normally shed kind of start getting stacked up and building up inside your pores, and a result of that can be breakouts. So I promise if you switch to a water soluble cleanser, or water soluble body wash, which they look and act very much like a shampoo, you will see a difference.
Andrea: Okay.
Desiree Stordahl: And, Andrea, I know it can be hard to give up soap, because I was a bit bar soap person until I started working for Paula's Choice.
00:43:38 But let me tell you, it has made a huge difference for me. I used to get the keratosis pilaris, the little chicken skin looking things, and that was when I was using bar soap. And since I stopped, that helped to clear it up quite a bit. And I actually use our Paula's Choice All Over Hair and Body Shampoo which can be used as both, a shampoo and a body wash. And it is also great because it is fragrance-free, and fragrance as we know in skincare isn't good for your skin.
00:55:05 It can cause more breakouts, triggers irritation. So, that is also a good option to look for.
Andrea: I will give it a try.
Bryan Barron: Andrea, we will send you one of those, too.
Andrea: Oh, thank you.
Bryan Barron: So you will be getting three products from us. I want you to have your fiancé put the BHA lotion on your back area at least once a day. You can do it at night, and then follow up with the Resist Anti-Aging Clear Skin Hydrator to help those marks. You don't have to wait for the BHA product to absorb.
00:55:41 You can apply them one right after the other. And tell him he will be a total sweetheart for doing this for you.
Andrea: I don't think he will mind at all.
Bryan Barron: Okay. And Andrea, keep in touch; in a few weeks, give these products a few weeks, and let us know how you are doing, and if we can be of further assistance to help you feel comfortable in that backless dress on your wedding day, just let us know.
Andrea: Thank you guys so much.
Bryan Barron: Thanks for calling, Andrea. Daynah, I think we have time for one more quick call.
Daynah Burnett: Okay. Well this is kind of a fun one. This is Joan in North Carolina. And she wants to know if there is anything in a skincare line that you can eliminate during the summer.
Joan: Hi, good evening.
Bryan Barron: Hello Joan.
Joan: How are you?
Bryan Barron: I'm good. So eliminate products during the summer?
00:56:32 You are thinking that, what, it's vacation and you are paring down your routine?
Joan: Well, actually I live in South Carolina, and summer is right around the corner. And I also work outside and inside all day long, so I find that two or three times a day I am sweating. And I'm thinking all of my products that I put on in the morning are just dripping off of my face, and I'm just putting my sunscreen on, so I'm wondering if I was going to eliminate some of them, to use the protection that I want, what should I eliminate?
Bryan Barron: Did we lose her?
Daynah Burnett: Sorry. No, we got her.
Joan: I'm sorry.
Bryan Barron: Joan, oh no, I think we are just having a bit of technical difficulty.
00:57:14 Honestly, for the situation you are in, the bare minimum would be cleanse your face in the morning, either at your sink or in the shower. And then follow up with a daytime moisturizer with sunscreen that is right for your skin type and personal preferences. That would be great. And then are you putting on makeup afterwards?
Joan: It's very light. Usually a tinted moisturizer I use. But I do want to keep the routine going, because I want to put my products on, but I just kind of feel like - even the skin lightening that I use in the morning, I'm wondering if I should just not use that, and use it at night, as opposed to in the morning.
Bryan Barron: Well, if those products are on your skin for an hour or two before you really get into the swing of your day, and the inside/outside, and the perspiring, I wouldn't worry too much about it. It is really more a concern if the layering combined with the perspiration and the humidity and what not is just really making your skin feel uncomfortable. So, it is not so much about them not working because you are sweating them off.
00:58:24 Does that make sense?
Joan: Yes, it does, actually. And I can usually pretty much keep it to a minimum. It is not like it is dripping, but I just kind of feel like after I put it all on, after one o'clock in the afternoon they are all gone.
Bryan Barron: There is going to be some dilution, but as long as they have been on your skin for an hour or two, you are going to get the majority of the benefits. So you can keep doing what you are doing, but in the interest of really saving time, at the bare minimum cleanse your face, put on your daytime moisturizer with sunscreen, finish with your makeup, and you are done.
00:59:00 And we will have to make sure that we send Joan a gift card for Paula's Choice products. Joan, we have your email, so we will be in touch with you. And we need to wrap up. Next week, Valentine's Day, we are off for the evening, but we are doing a rebroadcast of one of our most popular shows - perfect manicures and pedicures at home with nail expert Jaime Schrabeck. On February 21 we are going to be telling you our top secrets for an unbelievably smooth shave.
00:59:30 Everything from the best razors, to the best shaving creams, to the best shaving tips we have found over the years, work beautifully. And on February 28, top five tips for keeping oily skin under control. Don't forget to tune in every Tuesday night at 6pm. You can check out our podcast, transcripts of shows are available. Come visit us at PaulasChoice.com or Beautypedia.com anytime. Thanks for listening everyone. Have a good night.
Desiree Stordahl: Good night.
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