Many patients ask me for help getting clear, more even-toned skin. As I explain to them, there are two conditions that stand in the way of these skin goals: hyperpigmentation and redness.
Here’s what causes uneven skin tone and what you can do about it…
What is Hyperpigmentation and what causes it?
Hyperpigmentation (dark spots and patches), is due to overactive skin pigment cells that produce too much melanin pigment. The most common causes are:
- SUN. Ultraviolet (UV) radiation leads to freckles (cute when you’re younger) and sun spots (not so cute as time goes by). These can show up on your face, chest, arms, & legs.
- HEAT. Some patients tell me their spots get darker despite SPF and staying in the shade. As it turns out, heat from infrared rays (not just UV) also stimulates skin pigment cells.
- HORMONES. Estrogen is a major cause of melasma, a type of blotchy pigmentation that can develop during pregnancy or while taking birth control pills.
- HEREDITY. (Thanks, Mom!) If your female relatives have dark patches, you may be at greater risk, so all the more reason to take good care of your skin starting now.
How can you treat Hyperpigmentation?
- SUN PROTECTION. Go ahead and enjoy your time outdoors — just be sure to use an SPF 30 or higher “broad spectrum” sunscreen. I also encourage patients to eat cooked tomatoes and tomato juice (Bloody Marys count!), which are high in lycopene, an antioxidant that fights UV rays.
- USE SKIN-BRIGHTENING PRODUCTS. In the morning, protect and brighten with vitamin C, which helps control tyrosinase, the enzyme that causes overproduction of pigment. I like Kora Organics Noni Bright Vitamin C Serum because it contains 12% stabilized ascorbyl glucoside and it comes in an opaque container with a pump, so you know it’s fresh and potent until the moment you put it on. At night, resurface your skin with the Noni Night AHA Resurfacing Serum which contains lactic acid to gently lift off discoloration. Two to three times a week, exfoliate with the Turmeric Brightening and Exfoliating Mask to shed dead cells and reveal bright, new skin.
- IN-OFFICE TREATMENTS. For patients with stubborn spots, I may recommend prescription retinoids or physician-dispensed ingredients such as cysteamine; medical-strength peels (mandelic, pyruvic, salicylic, or trichloroacetic acids); IPL/laser; or medical microneedling with tranexamic acid.
What causes skin Redness?
Skin redness is due to excess blood flow to the skin. Some common causes include:
- SENSITIVE SKIN. If your skin gets easily irritated, itchy, red, and/or swollen, these are signs that it’s sensitive.
- ROSACEA. This condition causes red patches, enlarged veins, and pimples on the cheeks, nose, and chin.
- ECZEMA/“ANGRY” SKIN. Over-scrubbing and overuse of harsh ingredients can cause dry, flaky red patches.
- SUN/HEAT. Redness from sun damage can appear on the face, neck, and chest.
- HEREDITY. Some people are born with a rosy complexion (no need for blush!). But it can be more than you’d like.
How can you treat skin Redness?
- BE KIND TO YOUR SKIN. Squeaky-clean is good for your feet, but not your face! Use a gentle cleanser like Kora Organics Milky Mushroom Gentle Cleansing Oil, which dissolves makeup, sebum (skin oil), and dirt, without leaving you dry and tight.
- STAY COOL. One of my patients got blotchy red patches on her cheeks from her daily steam shower. After a hot shower, sauna, or sweaty workout, splash your face with cold water.
- CHOOSE CALMING PRODUCTS. Calm angry skin with natural anti-inflammatory ingredients such as Sea Buckthorn oil, found in Noni Glow Face Oil. I’ve had eczema since childhood and this is one of the few products that soothes my skin when I’m having a flareup. I also recommend Noni Glow Face Balm to my patients with rosacea and sensitive skin, since it contains calendula extract, a natural skin-soother.
- IN-OFFICE TREATMENTS. If your redness is unrelenting, or if you have pimples, large veins, or flaky patches, it may be time to see a dermatologist for medical treatment. I can also zap or inject enlarged facial veins; reduce redness with IPL and lasers; and prescribe gels that “get the red out” of your skin.
I hope this advice helps you achieve your most clear and even-toned skin!
Dr. Jessica Wu
Dr. Jessica Wu has been a Cosmetic Dermatologist in Los Angeles for over 20 years. A Harvard Medical School grad who is known for her expertise and artistry, she is a clinical researcher and teaches at the University of Southern California (USC). Dr. Wu is the best-selling author of Feed Your Face, which explores how diet profoundly affects our skin. She is a member of the American Academy of Dermatology and the Medical Council of the American Society for Nutrition. To learn more about Dr. Wu or to make an appointment, please visit www.drjessicawu.com and follow her on Instagram @drjessicawu.