'I'm A Derm And This Is Exactly How I Keep My Melasma Under Control'

'I'm A Derm And This Is Exactly How I Keep My Melasma Under Control'

02/04/2020

Dermatologists prescribe products to their patients all day long, but have you ever wondered which ones they personally use? Welcome to Derm Diaries, a new series where dermatologists share their skin woes—and solutions—so you can steal secrets from their skincare routines.

Claire Chang, MD, a board-certified cosmetic dermatologist and skincare expert at Union Square Laser Dermatology in NYC has dealt with acne since she was a teen. And while she still has “small acne breakouts,” it’s the acne scars (dark marks) mixed with melasma that concerns her now. “Some brown spots come from sun exposure (even exposure I had years ago), some from genetics, some from acne blemishing, and others from the aging process,” says Dr. Chang. “Although I’m strict about sun protection now, I still inevitably get pigmentation on my face. Melasma, in particular, is a stubborn and annoying condition that I developed in my late 20s and has been recurrent since.”

While Dr. Chang admits that she switches up her skincare routine depending on the season or whether her acne or pigmentation is worse, these are the products she turns to over and over again.

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Dr. Chang’s A.M. Routine:

She uses a gentle cleanser every morning.

“In the morning, I use a gentle cleanser to wash my face of any oil, sweat, and bacteria that may have accumulated in my pores overnight. I prefer gentle cleansers over harsh exfoliating scrubs, which can strip your skin of its natural lipids and leave it very dry. There is no need to strip your skin of all its natural lipids and oils because they’re actually working to protect your skin’s barrier. Many people with acne or acne blemishing use harsh physical scrubs with beads or salts but these can actually cause more inflammation and irritation, which can in turn worsen acne breakouts.”

Hydrating Facial CleanserCeraVeulta.com$14.99SHOP NOW

Toleriane Hydrating Gentle Face CleanserLa Roche-Posayulta.com$14.99SHOP NOW

Soy Face CleanserFreshsephora.com$38.00SHOP NOW

She always wears a vitamin C serum during the day.

“After gentle cleansing, I apply an antioxidant serum to my face every morning. Antioxidant serums—especially those containing vitamin C—protect the skin from sun exposure and environmental pollution all day long. Vitamin C is also useful in brightening the skin, lightening brown spots, and stimulating collagen. I typically use SkinCeuticals Phloretin CF or SkinBetter Alto Defense Serum, which contain an array of antioxidants and have a low risk of irritating the skin.”

Phloretin CF SkinCeuticalsdermstore.com$166.00SHOP NOW

Alto Defense SerumSkinbetter Scienceskinbetter.com$150.00SHOP NOW

She incorporates prescription topicals .

“When I have acne breakouts or know I may get a breakout (i.e. when I’m traveling, drinking wine more frequently, or around my period), I use two prescription topical acne medications: clindamycin lotion, a topical antibiotic that helps kill any bacteria that may be worsening my acne, and azelaic acid. I like azelaic acid over other topical acne medications becauseit’s a wonderful multi-functioning ingredient that can help in patients like me with a combination of acne, post-inflammatory hyperpigmentation, and melasma. It can even help calm rosacea.”

She changes her moisturizer with the seasons.

“During the humid summer months I reach for a lighter lotion or gel that won’t feel too heavy, like Neutrogena Hydroboost Gel. During the dry winter months when I need extra hydration, I switch to a thicker cream that contains ceramides like CeraVe Moisturizing Cream. During winter and even just as we mature, we lose important natural lipids like ceramides in our skin, so replacing them with your moisturizer is important.”

Moisturizing Cream CeraVeulta.com$18.99SHOP NOW

Hydro Boost Water GelNeutrogenaulta.com$23.99SHOP NOW

She applies (and re-applies) sunscreen every day.

“My favorite sunscreen is EltaMD UV Physical, which comes in a tinted formulation, so it doubles as my sunscreen and my foundation. I love the way it glides onto my skin smoothly without leaving a white residue or clogging my pores—a must when you have acne-prone skin. Plus it’s a pure mineral sunscreen—using zinc and titanium dioxide—which allows it to have broad-spectrum protection again all of the sun’s rays.”

UV Physical Broad-Spectrum SPF 41 SunscreenEltaMDdermstore.com$31.00SHOP NOW

Dr. Chang’s P.M. Routine:

  1. Double Cleanse
  2. Lightening Cream
  3. Retinol
  4. Glycolic/Salicylic Acid Pads
  5. Eye Cream
  6. Moisturizer

    She double cleanses every night.

    “I choose to double cleanse in the evening because I know I have a thick layer of makeup, oil buildup, sweat, and pollution sitting on the surface of my skin and clogging my pores. Cleansing twice, with an oil-based cleanser and then a water-based cleanser, removes acne-causing impurities and leaves my skin feeling much cleaner and smoother. The first cleanser breaks down dirt, oils, and makeup from the day while the second cleanser helps to hydrate and smooth my skin. But even when double cleansing, I stick with a gentle cleansers like the Then I Met You Cleansing Duo, as to not irritate my skin or worsen my acne.”

    The Cleansing DuoThen I Met Youthenimetyou.com$68.00SHOP NOW

    She uses a targeted hydroquinone cream for discoloration.

    “After cleansing in the evening, I apply a lightening cream to help improve the surface pigment of my dark spots and melasma. I’ll use prescription hydroquinone 4% cream for three months and then take a break for three months, alternating every three months. I take breaks between using hydroquinone because long-term use has been associated with a rare skin condition called ochronosis, that causes a blue-grey pigmentation on the skin. On my “off” months, I use another powerful lightening cream called SkinMedica Lytera 2.0. It uses multiple active ingredients, including niacinamide, tranexamic acid, and resorcinol that can help with brightening the skin and pigmentation.”

    Lytera 2.0 Pigment Correcting SerumSkinMedicadermstore.com$130.90SHOP NOW

    She switches up her retinoids with the seasons.

    “A topical retinoid is one of the staple skincare products for my skin. It helps me battle all of my skin problems at once (acne, acne scars, and melasma) while also being one of the most effective anti-aging ingredients.Retinoids can be drying and irritating, so I switch between different types of retinoids based on the season. During the dry winter months, I use an over-the-counter retinol (SkinBetter AlphaRet Overnight Cream) which tends to be gentler and less drying. When I am not worried about excessive dryness, I use a prescription retinoid (tretinoin 0.05% cream) nightly. I use a small dime-size amount over my whole face and neck nightly and always make sure to moisturize after to prevent excess dryness.”

    Age Defense Retinol ComplexSkinMedicadermstore.com$66.30SHOP NOW

    AlphaRet Overnight CreamSkinbetter Scienceskinbetter.com$125.00SHOP NOW

    She swaps her retinol with a peel pad a couple times a week.

    “Twice a week I switch out my retinol for a glycolic/salicylic acid peel pad. I repeat: Do not use retinol on the same nights as the peel pad, as the combination causes too much irritation. These help exfoliate my skin, clear out my pores, prevent acne, improve acne marks, and lighten my melasma.”

    Max Complexion Correction PadsPeter Thomas Rothsephora.com$46.00SHOP NOW

    Rapid Resurfacing PeelMuradsephora.com$46.00SHOP NOW

    She makes sure to apply eye cream.

    “The skin around the eyelids is the thinnest on the body and therefore, the first to show signs of collagen loss. I like to look for eye creams that hydrate to plump the skin and reduce fine lines as well as ones with active ingredients like peptides and antioxidants to protect against damage. I’ve been using Neocutis Lumiere Eye Cream which contains antioxidants to help protect the skin, peptides to help stimulate collagen, and caffeine to help with swelling.”

    Lumiere Bio-Restorative Eye CreamNEOCUTISdermstore.com$97.00SHOP NOW

    She also treats her skin with laser treatments like Clear and Brilliant.

    “I admit that my skincare regimen only gets me so far in helping to treat my acne scarring, brown spots, and melasma. Topical treatments help with the surface of the skin, but acne scarring and pigmentation are often in the deeper layers that only laser treatments can reach. The Clear and Brilliant is one of my favorites. It’s a low energy resurfacing laser that helps even out pigmentation, lighten brown spots, and improve post-inflammatory hyperpigmentation. I get these monthly on my face.”

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