Pursuit of Flawless Skin

Written on: Jun 19, 2019
By: Shari Hicks-Graham

Many of us are in pursuit of flawless skin; meaning the kind that never needs makeup or digital correction on social media. But, we also are aware that occasional skin irritation or blemish is annoyingly common. Even people with the clearest of complexions find themselves with a skin bump or two from time to time. However, one of the most frustrating issues is when these blemishes linger and leave dark spots behind. This is a problem that people with darker skin types face regularly, but it can affect anyone regardless of skin tone. In this post, I discuss why discoloration happens and will illustrate some methods for treating it and preventing it from occurring.

Inflammation is part of the body’s mechanism for healing itself. It occurs when the immune blood cells flood an area where a problem exists, like an acne pimple, a rash, or an ingrown hair.  Inflammation also rushes to help heal the skin after excessive sun exposure or sunburn. Don’t get me wrong, inflammation is necessary, but in the setting of hyperpigmentation, too much of a good thing can be bad! Initially, an area of skin inflammation may look a bit pink, reddish or purple, but over time, it may become brown or hyperpigmented. This happens because the inflammatory cells communicate with melanocytes in the skin, causing an increase in melanin in the affected areas. This migration of melanated cells into the skin causes hyperpigmentation.  This melanin can be found in the superficial layer of the skin (epidermis) or in the lower portion of the skin (dermis). The deeper the inflammation with associated melanocytes, the more difficult it is to resolve the brown discoloration, thus leading to prolonged hyperpigmentation. Individuals with deeper skin tones simply have more melanin present in the skin to begin with, and so discoloration is a greater issue.

So, what can we do to treat the discoloration? First, simply try and avoid skin inflammation. Our body has a way of alerting us about inflammation through the symptoms of pain, swelling, and redness. If you feel any of these things in your skin, pay attention and try to resolve the issue right away. The most common reason why people experience discoloration on the face is acne.  In this case, products that work to reduce inflammation like benzoyl peroxide, adapalene, glycolic acid, dapsone, and azelaic acid are helpful. Be sure not to excessively dry the skin out around the pimples, and never ever squeeze or pick acne! Also, be sure to treat the skin gently and consider products that are more soothing than they are harsh. Choose one or two treatments, be consistent and don’t skip the moisturizer with sunscreen. If home treatments or over-the-counter products don’t work, see a board-certified dermatologist to help you craft an appropriate care routine. Also, keep in mind that facial hair may contribute to acne in a major way. If you remove unwanted hair, consider that your method may exacerbate the acne.  Plucking hairs with tweezers, waxing, or shaving may irritate sensitive skin. Ingrown hairs may ensue and can look like acne, but are tougher to resolve because hair is involved. Laser hair removal can be a huge difference maker, so be sure to see a dermatologist with experience in treating people with your hair and skin type for best results.

Dry skin (eczema) rashes are associated with inflammation and can be tricky, especially in the summer. If they are not managed carefully, discoloration may ensue. Use anti-inflammatory moisturizers and creams to help hydrate the skin. Simple hydrocortisone creams can be useful.  Remember that fragrance, dyes and sun exposure can be tricky on sensitive skin, so be careful! A simple prescription to prevent scratching and further skin discoloration can make a huge impact on poison ivy or heat rashes, so be resourceful and reach out to your healthcare provider instead of suffering in silence!  

Lastly, not to overstate the obvious, but the sun can definitely cause unwanted permanent areas of pigmentation on the skin. Some sunspots are simply deeper, larger freckles called lentigines, and other larger deeper patches are part of a condition called melasma. Lentigines and melasma are definitely more difficult to treat than prevent. Sunscreen and hats are paramount in the effort to prevent these issues in the first place. These conditions may be treated with topical retinoids, fade creams, proper skin-type appropriate chemical peels, and even select lasers.  The American Academy of Dermatology still recommends the use of daily broad-spectrum sunscreen SPF 30 or higher, along with hats to help prevent sun damage for all people, regardless of skin color.

Let us know if you have ever dealt with tough to treat skin spots. Have you found any good tricks for clearing them up? Remember to use an approach that is consistent, slow and steady to best manage areas of discoloration. Beware of any products that cause irritation or promise rapid results because they may make matters worse. Also, start early and be intentional with self-care because you are definitely worth the time and effort. Share any questions with us on social media & feel free to let us know if you want me to cover any other pressing questions or blog topics. Next month, I will write about another important hair & scalp condition, so be sure to stay connected with us and share this info with anyone you feel would benefit.  

LivSo Free & Clear,

Shari Hicks-Graham, MD