Skin Care Products for Hyperpigmentation

As a Santa Barbara cosmetic surgeon who also specializes in skin care, I get a lot of patients who inquire about reversing hyperpigmentation. They may call them sun spots, “liver spots”, or “age spots”, and essentially what they are referring to is the darkening of their skin that appears over time and can look like freckles, patches, abnormal pigment clumps, or “stains” on the skin. Most hyperpigmentation is the result of sun damage (or photodamage) which is repeated and prolonged exposure to the sun’s UV rays.

There are different ways to address sun damage and pigmentation issues, but I will devote this blog post to the products that I have seen to be the most effective at reducing unwanted pigmentation. While many mass market skin care products that are available from drug stores to high end department stores make claims to reverse or fade spots, their effectiveness is not as great (if they are effective at all) as medical-grade skin care products. Mass market products contain lower active ingredients so they can be used by a large audience without many unwanted problems. Pharmaceutical grade skin care products, on the other hand, have higher active ingredients which renders them more powerful – and more apt to get the job done!

My recommendation for the skin care products listed below stems from their excellent reputation, their high therapeutic value, and our clients’ satisfaction. Also, at some point, these products have all been used by me and my staff at Evolutions Medical & Day Spa in Santa Barbara and we have personally witnessed positive changes in the skin from them.

The entire line of NIA24 products are designed specifically to address photodamaged skin and to help prevent future damage. They contain a patented molecule called Pro-Niacin, derived from Niacin (Vitamin B3), that utilizes a MicroNutrient Delivery system which allows it to cross the epidermal barrier and penetrate the epidermis in a continuous release fashion for up to 24 hours. This is what makes these products different from any other Niacin containing products. NIA24 truly creates healing from within and will lessen pigmentation, brighten and firm the skin. 

Obagi is one of the most recognized skin care names globally. They are known for their prescription-strength product lines that truly transform the skin. Obagi is offered in many physicians’ offices worldwide. Obagi has an array of products for different skin concerns. Hyperpigmentation would be best addressed by Obagi’s Nu-Derm System. This system contains several products that help normalize the skin as it increases cell turnover, lightens or erases dark pigment spots and other photodamage, improves skin elasticity, lessens the appearance of fine lines and wrinkles, and brightens the overall complexion.  

This scientifically advanced skin care line provides the most technically researched, results-driven formulations available today. PCA products are only available through licensed skin health professionals that have been trained and certified by PCA Skin. PCA has a Pigment Gel with Hydroquinone (HQ) or a Pigment Gel HQ Free (no hyrdoquinone but other ingredients such as kojic acid, azelaic and lactic acids to encourage an even skin tone) that are less aggressive than Obagi’s Nu-Derm system but give an alternative way to decrease the formulation of melanin (the brown pigment) over time.

Tretinoin is the chemical name for retin-A (retinoic acid) and is a vitamin A derivative that has been shown to have many beneficial effects on the skin such as 1) increasing cell turnover, 2) decreasing pore plugging (which means fewer pimples, white and blackheads), 3) decreasing abnormal cell differentiation (which means less likelihood of skin cancer) and 4) anti-aging effects. Retinol is a “cousin” of retin-A that is converted to retinoic acid in the skin but at a much lower concentration. Retin-A is best used on a regular basis at night for the long term and is known for gradually fading hyperpigmentation spots over time.

There are faster ways to fade pigmentation (such as non-invasive aesthetic treatments) but if you choose to use any of the above products and give them some time and patience, I think you will be pleased with the result.

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I am a Santa Barbara cosmetic surgeon who specializes in facial rejuvenation cosmetic surgeries and skin care. If you are interested in scheduling a consultation, call my office at 805-563-0000.

Non-Invasive Treatments for Sun Damaged Skin

This Fall in Santa Barbara we were treated to an extended summer. Lots of clear, sunny and warm days drew us outside for beach days, backyard barbecues, and hikes in our local mountains. While we were enjoying our beautiful weather, many of us were unknowingly exposing our skin to photodamage (sun damage) due to repeated and/or prolonged exposure to the sun’s rays.

For some of us, the sun damage appears almost instantly (usually in the case of a bad burn) while others may not show any “damage” for many years. The photodamage can present itself in different ways:

  • Abnormal pigment clumps (often referred to as “age spots” or “liver spots”)
  • Wrinkles and sagging of the skin (caused by damage to the collagen and elastin network in the dermis)
  • Neoplastic changes (such as pre-cancerous or true skin cancer)

As winter approaches, some people may notice more “freckles” or discoloration on their face, shoulders, chest, and hands (the places that are exposed to the sun most frequently). As a Santa Barbara cosmetic surgeon, I will receive lots of inquiries about how to reverse the sun damage and/or prevent further damage from taking place. The good news is that there are now a number of way to erase sun damage that ranges from medical grade products all the way to the operating room.

While many people would love to have the majority of their sun damage, acne and/or facial scarring, skin irregularities and pre-cancerous lesions removed in one process (via a cosmetic surgery procedure called Chemabrasion), the reality is that many people do not have the downtime required for healing and/or the financial means to have this done. If this is the case, then there are non-invasive medical procedures that require little (or no downtime) that give a nice result. Some of these procedures take a series of treatments to yield the maximum result desired.

These are the non-invasive aesthetic treatments that I recommend for treating mild to moderate sun damage:

Chemical Peels
Before lasers were available, photodamaged skin was often treated with chemical exfoliation in order to cause the surface damaged tissue to peel off exposing cleaner, fresher, and younger skin underneath. Peels involve the application of an acid solution to the skin and are still appropriate treatments today – especially for larger areas on the body that may be relatively expensive to treat with light energy alone. More aggressive peels (using stronger acids) may also help fine lines and wrinkles. At my Santa Barbara cosmetic surgery office we have some protocols that combine both peels and light-based modalities to get the best of both!

FotoFacial RF
This non-ablative procedure uses both intense pulsed light (IPL) and radio frequency (RF) to improve the color imperfections of your skin. The inventors of this treatment found that combined IPL and RF give better results than IPL alone and patented the name spelled with an “F” – FotoFacial. So any procedure spelled with a “Ph” – PhotoFacial – uses only IPL energy. A FotoFacial will improve the skin’s texture and appearance through reduction of redness, age spots, sun damage, liver spots, and uneven pigmentation. There is no downtime after a FotoFacial and it can be used on the face, neck, chest, and backs of the hands.

Laser Genesis
The Cutera laser company developed a unique treatment for “ruddy” skin called Laser Genesis. This Nd:Yag laser delivers thousands of low energy pulses to the rosy skin and gently causes the small vasculature to “seal off”, resulting in a more normal appearance without any downtime.
Sublative Rejuvenation + DNA Repair. This radio frequency skin resurfacing series is great for ALL skin types. It will improve the skin’s appearance and tighten skin. The DNA CryoStem Therapy that accompanies this treatment gives the skin an additional boost. The flawless stem cells that are introduced right after the resurfacing will influence the older cells to replicate healthier, stronger, more youthful-looking skin cells, repairing sun damage, acne scars, and mild wrinkles.

Fractional CO2 Skin Resurfacing
Laser energy is delivered to the skin in thousands of tiny pulses that create minute holes and injure only a fraction of the skin. These holes cover over very rapidly so “downtime” is usually short. As the spacing between the holes and the depth of each hole can be controlled, this type of resurfacing can be “titrated” to the problems being addressed. One treatment can produce a 40% improvement. The procedure will not only address pigmentation but it can also improve fine lines and wrinkles, textural irregularities, and acne scars. The resurfacing procedure also encourages new growth of elastin and collagen which will tighten the skin.

Sun damage happens to everyone – sometimes even more so living in sunny Southern California and in Santa Barbara where I practice. Treating sun damaged skin helps to reverse hyperpigmentation as well as improve the overall appearance and health of the skin. This holiday season give yourself the gift of renewed skin that will last you through the winter and beyond!

All of these medical aesthetic treatments can be done at Evolutions Medical & Day Spa in Santa Barbara. Contact Evolutions Medical & Day Spa at 805-687-0212. 

Santa Barbara Cosmetic Surgeon Talks About Getting Rid of Unwanted Pigmentation

With summer winding down, we’ve had a lot of our Santa Barbara Cosmetic Surgery Center clients inquiring about how to get rid of excess pigmentation (often referred to as sun spots, “liver” spots, or hyperpigmentation) that have resulted from sun overexposure and/or the fluctuation of hormones that happen as we age. Clients want to know how they can combat unwanted pigmentation on their own, using at home skin care products, and also how we can help them in the medical office.

The good news is that there are lots of options! The better news is that you can learn about these options at the educational event, Brightening and Tightening, this Wednesday, September 26th, that is hosted by Evolutions Medical Spa, where Santa Barbara cosmetic surgeon Dr. Terry Perkins (the founder and Medical Director of Evolutions) will be speaking about skin rejuvenation options that are non-surgical and have a great success rate.

Some of the evening’s event will be dedicated to skin tightening (through such revolutionary treatments as Total Tightening which combines the top two non-invasive skin tightening procedures into one highly effective treatment) the other part of the evening will be dedicated to skin lightening where Dr. Perkins will speak about a variety of medical grade products and professional treatments that can control excessive pigmentation and help create a more uniform tone to your skin. While not giving away Dr. Perkins’ entire presentation, we will give you a sneak peek on what you may hear about:

  • The FotoFacial RF™ is one of the safest and most effective intense pulsed light (IPL)-based treatments for excessive pigmentation that is available today. Don’t mistake it for a “PhotoFacial” offered by other doctors’ offices because the FotoFacial RF™ is a trademarked procedure that was co-developed by a dermatologist (Dr. Patrick Bitter, Jr.) and a plastic surgeon (Dr. R. Stephen Mulholland) that brings together the best of aesthetic dermatologic skin care and cosmetic plastic surgery into one non-invasive treatment. Clients love the FotoFacial RF™ because many achieve a noticeable and consistent degree of improvement after completing a series.
  • Obagi Medical Products are high quality medical products that are sold only to physicians. Obagi has multiple lines for many skin concerns such as acne and rosacea, but their signature Nu-Derm System is truly transformative. It is often advertised as “anti-aging” whereby it replaces old damaged skin cells (that cause premature aging) with healthy new cells and along the way it also corrects photodamage such as age spots, sallowness in the complexion, and discoloration (or hyperpigmentation). It is a system that takes dedication and time, but the end result is all worth it!
Sometimes clients like to start small before diving into a bigger commitment such as a FotoFacial series or the Obagi Nu-Derm system and they ask Dr. Perkins what he recommends. In this case, Dr. Perkins’ number one recommendation is to stay out of the sun and use sun protection year round, and his next recommendation, for those seeking some reprieve from sun damage or pigmentation issues, is consistent use of an AFA Exfoliating Gel.  
The AFA Exfoliating Gel is powered by acidified amino acid and is good for treating sun damaged skin, overly pigmented skin, and acne-prone skin. It stimulates new cell growth, which makes skin appear “younger”, by removing the outer layer of dead cells while restoring the natural moisture-retaining amino acid system of the epidermis. AFA’s break down to monocanic acid, a natural UV filter, that helps the skin better protect itself from harmful UV light. To top it off, AFA gel provides a stable antioxidation to establish a healthy skin environment.
AFA Exfoliating Gel comes in different strengths, making it suitable for all skin types and does not cause a great amount of dryness (if any) or irritation that can be associated with other exfoliating products. Use it daily, or three to five times per week, on freshly cleansed skin (underneath your sunscreen or make up) depending on your skin. Being on an AFA Exfoliating Gel will provide your skin with the immediate benefits of fresher, healthier skin cells and is also be a great way to prep the skin for more aggressive treatments such as the FotoFacial RF™. 
The FotoFacial RF™, Obagi skin care products, and AFA Exfoliating Gel products are all available at Evolutions Medical Spa in Santa Barbara
If you would like to attend the educational event at Evolutions Medical Spa on Wednesday, September 26th, please call Evolutions at 805-687-0212 to reserve your seat today. There is no charge to attend the event. Light refreshments, a raffle, and promotional pricing will be available to all attendees. 

Ask Santa Barbara Cosmetic Surgeon Dr. Perkins: Vitamin B Skin Care

Dr. Terry Perkins answers questions from clients about cosmetic surgery procedures and skin care. If you have a question for Dr. Perkins, please email him with “Ask the Cosmetic Surgeon” in the subject line. 

Q: Hi Dr. Perkins, I keep seeing skin care products that have Vitamin B in them and have recently read a few articles in beauty magazines that boast about the benefits that Vitamin B can have on skin. Is Vitamin B really that great for the skin? And if so, what products do you recommend? Thanks! Theresa, Santa Barbara

A: Hi Theresa, you have posed a great question. I agree that there has been a lot of press about vitamin B products lately. Vitamin B in skin care products is often referred to as niacin and that specifically refers to B3. To answer your question, yes, niacin does have the potential to rejuvenate your skin but there is a caveat. Most of the products on the market, that are not medical grade, probably do not contain enough vitamin B to be effective in changing your skin.

In my opinion, the best niacin skin care products on the market today are NIA24. These products contain a patented molecule called Pro-Niacin that penetrates the skin to deliver niacin directly to the cells, energizing them and encouraging normal cell turnover. It also protects and repairs the DNA in the skin cells that became de-normalized due to aging and UV sun damage. Also, Pro-niacin stimulates the release of the hormone leptin, a natural repair hormone, that improves skin tensile strength.

What sets NIA24 apart from the other niacin containing products is that they have developed a MicroNutrient Delivery system that allows the beneficial ingredients to penetrate the epidermis in a slow, continuous release, allowing the molecule to bio-convert to its working form and providing your skin with its protective powers 24 hours a day.  I’ve added an image in from the NIA24 website to better illustrate this concept:

NIA24 is good for sun-damaged, rosacea, hyper-pigmented, and allergic skin. It is fragrance, color-free, dye-free, and non-comedogenic. While we carry select NIA24 products at Cosmetic Surgery CenterEvolutions Medical Spa Santa Barbara has a more robust selection. Call them at 805-687-0212 or visit them downtown to purchase your NIA24 products. 

Elure Skin Lightening in Santa Barbara

If you are looking for a quicker way to reduce skin pigmentation, Elure Advanced Skin Lightening therapy is the answer for you!

Clinical studies showed that 82% of subjects demonstrated a significant decrease in their melanin and 91% of subjects showed an overall improvement in fairness and skin tone in just 28 days (when used twice a day)! This is much quicker than other methods of skin lightening available on the market today.

Elure FAQs:
What is Elure?
Elure is a topical cosmetic only available from a physician’s office that reduces dark-colored pigment (sun damage, liver spots, hyperpigmentation) on your skin.

How does Elure work?
Elure’s patented natural enzyme, Melanzyme™, destroys the melanin accumulating on the skin’s surface.
How is Elure different than other lightening products (such as hydroquinone)?
Other lightening products address dark spots by blocking the production of melanin deep within the skin, eventually causing the discoloration to fade over time (which can take many months). Elure targets the melanin that has already accumulated and breaks it down.
What Elure products are available?
  • Advanced Skin Lightening Lotion: a rebalancing lotion to brighten, soften, soothe and replenish the skin.
  • Advance Lightening Night Cream: a recovery hydration complex for a brighter, softer tone.
  • Foaming Facial Wash: use Elure’s Advanced Skin Lightening Technology in combination with the Advanced Facial Wash to remove dirt and dead skin debris for a radiant skin appearance.
Have you heard the buzz on Elure?
Featured in Allure magazine as “Top New Product of the Year”. Featured on the Today Show with Hoda and Kathy Lee as a “real game changer”.
Where can I buy Elure in Santa Barbara?
Elure is only available in Santa Barbara at Evolutions Medical Spa located at 1309 State Street, on the same block as the historic Arlington Theater. Contact Evolutions at 805.687.0212.