Hyperpigmentation Treatments for face: Put Down the Lemon Slice

With endless options, finding the right hyperpigmentation treatment for face can be exhausting. Dozens of treatments are recommended on skincare blogs, from topicals to in-office procedures to DIY remedies. So to cut through the noise, we got advice from a couple of expert derms.

WHAT IS HYPERPIGMENTATION?

Hyperpigmentation, or uneven skin tone, is an increase in melanin that results in flat brown spots or patches on the skin that are darker than your usual complexion. Melanin is the natural pigment that determines your skin, hair, and eye color. But when it’s overproduced, the skin can look spotty or patchy. 

Sun exposure, air pollution, hormonal changes, and skin inflammation from acne or skin damage can all be culprits for an uneven skin tone. Hyperpigmentation can affect people of all skin types and colors, and while it is generally harmless, it can significantly impact one's appearance and self-esteem. 

Before you dab your face with a lemon slice or jump on the latest buzzy solution from Allure, slow down and think about the options. Some treatments can cause more harm than good. We chatted with board-certified dermatologists Dr. Lana Kashlan and Dr. Sheila Krishna to get the 411 on hyperpigmentation treatments that actually work.

WHICH AT-HOME HYPERPIGMENTATION TREATMENT FOR FACE IS RIGHT FOR YOU?

If you want a fresher-looking complexion, Dr. Kashlan recommends that you start with a topical hyperpigmentation treatment for six to eight weeks. “If you’re still not happy with improvements in the skin tone,” she says, “doing an office procedure like peeling would make sense.” So try out dermatologist-approved skincare products before getting a more involved in-office procedure.

Before you choose a treatment option, though, talk to your dermatologist. “Uneven skin tone can mean a lot of different things,” Dr. Kashlan tells us. “Sometimes it’s related to environment, sometimes it’s related to genetics, sometimes it’s related to hormonal changes.” So work with your dermatologist to rule out underlying medical causes to get the right solution for your skin. Then consider these skincare topicals recommended to treat hyperpigmentation.

RETINOIDS

Retinoids like retinol and Tretinoin are essential wrinkle smoothers and acne fighters. But they are also a great hyperpigmentation treatment for face. They’re chemical exfoliants—working their magic at a deeper level than facial scrubs, which only touch the surface.

According to Dr. Kashlan, retinoids work by dispersing melanin granules that are “clumping together under the skin surface causing the discoloration.”

Our favorite retinoid is Tretinoin. What is Tretinoin? It’s the only FDA-approved retinoid for photoaging (aka premature skin aging)—which could be causing your hyperpigmentation. It’s also 20 times more potent than over-the-counter retinol1 and has over 50 years of research to prove its safety and efficacy.

One study shows that Tretinoin is more effective at exfoliating and stimulating new cell growth than glycolic acid, another chemical exfoliant, and shows results faster2. Check out Tretinoin before and after photos - you won’t believe the difference!

Night Shift is a dermatology-grade Tretinoin serum tailored to your skin and prescribed by doctors online; no in-office visit required. Check out our blog post to learn about all the Tretinoin cream benefits.

Use retinoids at night, as they can make your skin more sensitive to the sun if used in the morning. You may experience what’s referred to as “Tretinoin peeling” while your skin adjusts to retinoids, so be sure to include a hydrating moisturizer as part of your routine.

GLYCOLIC ACID

Glycolic acid is a chemical exfoliant that works similarly to retinoids to brighten the complexion.

You can buy low-concentration glycolic acid over the counter as a hyperpigmentation treatment for face. It may be less irritating than derm-strength retinoids but also less potent. You can get higher-strength glycolic acid peels from a dermatologist. These are more likely to cause irritation and should be done occasionally, as long-term use can damage collagen in the skin.

We don’t recommend using glycolic acid and retinoids (or other chemical exfoliants) together unless directed by a dermatologist. Most people will get what they need out of one of them. If you do use them together, it’s best to use them on different days to avoid redness and sensitivity.

Glycolic acid can make skin more susceptible to sun damage, so use it at night to reduce sensitivity. And don’t skip your SPF.

SALICYLIC ACID

Salicylic acid is an effective chemical exfoliant that won’t make you more sensitive to the sun3, so you can use it whenever it’s convenient for you. Well known for its acne-fighting abilities4, salicylic acid can be your one-two punch for reducing acne while treating and preventing uneven skin tone from acne scars. Salicylic acid is proven to be effective for treating hyperpigmentation, including for patients with darker skin5.

Salicylic acid and tretinoin are comparable for fighting acne6. But you’re better off combatting other signs of photoaging, like fine lines and wrinkles, with Tretinoin.

NIACINAMIDE

Niacinamide is a powerful hyperpigmentation treatment that has a low risk of irritation. “Niacinamide,” says Dr. Kashlan, “blocks the transport of melanin from the melanocytes, or the pigment-producing cells, to the keratinocytes, or the skin cells.”

As a bonus, niacinamide prevents UV damage7 and repairs DNA after sun exposure8. So it’s an ideal skincare sidekick to prevent dark spots from coming back.

One study proves niacinamide’s effectiveness for treating melasma (hyperpigmentation associated with hormonal changes). It’s a first-class alternative to hydroquinone, a traditional melasma treatment, with fewer side effects 9.

You can use niacinamide as part of your morning and evening routines and as hyperpigmentation treatment for face.

ARBUTIN

Arbutin is a lesser-known skin-brightening serum that earns its place on your bathroom shelf. With few side effects, it’s a great option for dry or sensitive skin types.

Arbutin treats skin discoloration by inhibiting tyrosinase—an enzyme used to produce melanin.

It plays well with your other skincare actives and can be used morning or night.

VITAMIN C

Vitamin C is key for preventing sun damage that can lead to dark spots and other signs of photoaging.

Add a vitamin C serum to your morning skincare routine to boost your skin’s antioxidant protection against the sun’s free radicals.

Vitamin C can be drying, but that can be easily counteracted by following up with a hydrating moisturizer.

AZELAIC ACID, KOJIC ACID, AND LICORICE EXTRACT

These three often come as a combined formula, and Dr. Kashlan recommends using them together to reap their benefits. Like arbutin and vitamin C, azelaic acid, kojic acid, and licorice extract inhibit tyrosinase to keep dark spots at bay. They’re worth considering if you want an effective, natural solution.

These three “are all safe to use during pregnancy, as well,” according to Dr. Kashlan. So they can be an ideal treatment for melasma, which is common during pregnancy. Of course, check with your OB-GYN before starting any kind of treatment.

HYDROQUINONE

Hydroquinone is an effective skin brightener that acts as a bleach by decreasing the pigment-producing cells in your skin. It’s generally okay for lighter skin tones but may worsen hyperpigmentation on darker skin tones. And it’s more intense than most people need.

We share this skincare active with caution. The FDA has gone back and forth on the safety of this skincare active, and it’s banned in several countries. So consult with your dermatologist before using hydroquinone as hyperpigmentation treatment for face.

WHICH IN-OFFICE HYPERPIGMENTATION TREATMENT FOR FACE TO GET FROM A DERMATOLOGIST?

Not getting the results you want at home? Talk to your dermatologist about the in-office procedures they offer. Some are more expensive than others or require more recovery time, so it’s worth knowing your options before you settle on a solution.

MICRODERMABRASION

Microdermabrasion is a cost-conscious in-office treatment for hyperpigmentation that requires several visits. It removes the outer layer of your skin to stimulate new cell growth.

 

Side effects are minor, and most go away in a few hours. It will make you more sensitive to the sun, so limit time in the direct sun and use sunscreen while your skin recovers.

CHEMICAL PEELS

Chemical peels typically use higher concentrations of actives like glycolic acid than you can get at the store.

Like microdermabrasion, chemical peels remove the outer layer of skin to make way for new skin growth. The number of sessions, side effects, and recovery time depend on the intensity of the chemicals used and your skin goals. Light peels will cause mild irritation, while deep peels require painkillers after treatment and can take months for the redness to subside.

INTENSE PULSED LIGHT (IPL) TREATMENTS

IPLs target individual dark spots, while microdermabrasion and chemical peels typically address the entire face. So IPL treatments are ideal for large dark spots versus all-over patchiness. Depending on your goals, you may need to go in for three to five sessions.

Side effects usually include minor sensitivity after treatment.

LASER RESURFACING

Laser resurfacing is more painful and intensive than other in-office hyperpigmentation treatments for face but usually only requires one session. Like IPLs, laser treatments target individual dark spots to make room for new skin growth.

 

You’ll get an anesthetic or sedative for treatment and a painkiller afterward. Depending on the intensity of the treatment, redness can take anywhere from a couple of months to a year to go away completely, so talk to your derm about what the healing process will look like for your specific treatment.

Laser treatments can cause skin to darken in patients with darker skin tones. But that can be counteracted with a lightening agent after the procedure.

HYPERPIGMENTATION REMEDIES TO AVOID

Not all remedies are created equal. And when it comes to hyperpigmentation, there are some you should absolutely avoid. Chief among them are physical exfoliant facial scrubs and DIY remedies. These can cause irritation and cause more harm than good - or just not work.

FACIAL SCRUBS

As popular as facial scrubs are, Dr. Krishna warns that physical exfoliants like coffee grounds, nuts, and sugar can “irritate the skin, cause more oil production, or even leave scars and marks on the skin.” That makes it harder for you to reach your skincare goals. With a facial scrub, you can’t guarantee even exfoliation. So you may worsen the texture and appearance of your dark spots.

Opt for a chemical exfoliant instead like retinoids, salicylic acid, or glycolic acid. These cover your face more evenly and penetrate the skin for a more effective exfoliation.

HOME REMEDIES FOR HYPERPIGMENTATION

There are a plethora of DIY remedies on the internet declared to treat hyperpigmentation. Some of these just don’t work, while others can cause more harm to your skin. These are just a few:

As far as what to avoid, Dr. Kashlan warns, “I would absolutely, never, ever, ever put lemon juice on the face or on the skin.” Lemon juice for hyperpigmentation is a no-go. It’s very acidic and can cause burns, irritation, and dryness. Red onion, tomato paste, and apple cider vinegar are also very acidic and should stay off your face.

The others are fine and commonly used, and some have known benefits. Aloe vera is known for healing the skin. Green tea extract and turmeric are anti-inflammatory. Yogurt can be helpful for acne. And papaya works for exfoliation. But, Dr. Kashlan says, “I don’t believe in DIY remedies because you really cannot control the concentration of the active ingredients.”

There could be irritating ingredients or natural chemicals in the remedy you’re using, so Dr. Kashlan says, “I really would recommend sticking with regulated formulations instead.”

Rather than relying on a home-brewed concoction, use dermatologist-approved formulations with studies that prove their safety and efficacy as hyperpigmentation treatment for face.

SKINCARE ROUTINE FOR HYPERPIGMENTATION

Uneven skin tone itself is generally harmless, though it can be a sign of an increased risk for skin cancer. So it’s worth developing a preventive skincare routine that provides a barrier to skin-damaging elements like the sun and air pollution that are common instigators for hyperpigmentation.

MORNING SKINCARE ROUTINE

  1. Use a gentle face cleanser to wash away pollutants, dirt, bacteria, and oil buildup that can cause hyperpigmentation.
  2. Treat with an antioxidant like vitamin C or niacinamide to fend off free radicals throughout the day.
  3. Protect the skin with a hydrating moisturizer to maintain skin health.
  4. Shield the skin against the sun’s damaging rays with a broad spectrum sunscreen with an SPF of 30 or higher.

EVENING SKINCARE ROUTINE

  1. Use a gentle face cleanser to wash away pollutants and dirt from the day.
  2. Treat with a mild chemical exfoliant like retinoids, glycolic acid, or salicylic acid to keep skin pigmentation even.
  3. Protect the skin with a hydrating moisturizer.
  4. Remember: Skincare is personal. What works for someone else might not work for you. Use this as a base and swap in products as you learn what works for your skin. Talk to your dermatologist about your skin concerns and history so they can guide you to the right treatments.

Be patient with your new regimen. Real results don’t happen overnight. Check in with your dermatologist if you don’t start seeing an improvement in six to eight weeks. And, of course, stop any treatment that’s irritating your skin. Your dermatologist can help fine-tune your routine.

PRODUCT SUGGESTIONS

Night Shift

Night Shift is our tailored retinoid. It prevents and treats hyperpigmentation, melasma, sun spots and dark spots by dispersing melanin granules. It also helps with uneven skin tone, enlarged pores, and acne and includes Niacinamide to calm redness and prevent moisture loss. 

 

Liquid Cloak

Besides its antioxidative property, vitamin C is photoprotective, anti-pigmentary, anti-inflammatory, and aids collagen synthesis. Liquid Cloak is designed to protect and restore skin while fighting hyperpigmentation.

Daily Sip

Specifically designed to work with retinoids, Daily Sip is a hydrating moisturizer that effectively strengthens the skin barrier while preparing it to handle treatments better. It’s formulated with hyaluronic acid and is rich with ceramides, ingredients proven to increase skin hydration.

Be patient with your new regimen. Real results don’t happen overnight. Check in with your dermatologist if you don’t start seeing an improvement in six to eight weeks. And, of course, stop any treatment that’s irritating your skin. Your dermatologist can help fine-tune your routine.

Skincare can be overwhelming, so feel free to reach out with any questions. We’re always happy to help.

Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/

Campos, P., et al. (2015, January 6). Comparative Effects of Retinoic Acid or Glycolic Acid Vehiculated in Different Topical Formulations. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302967/

Kornhauser, A., et al. (2009, May 2). The Effects of Topically Applied Glycolic Acid and Salicylic Acid on Ultraviolet Radiation-Induced Erythema, DNA Damage and Sunburn Cell Formation in Human Skin. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791365/

Decker, A., BS, MA & Graber, E.M., MD (2012, May). Over-the-counter Acne Treatments. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366450/

Desai, S.R., MD, FAAD (2014, August). Hyperpigmentation Therapy: A Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142815/

Babayeva, S., et al. (2011, March). Comparison of tretinoin 0.05% cream and 3% alcohol-based salicylic acid preparation in the treatment of acne vulgaris. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20666879/

Damian, D.L. (2010, April 1). Photoprotective effects of nicotinamide. Retrieved from https://pubs.rsc.org/en/content/articlelanding/2010/PP/b9pp00146h#!divAbstract

Thompson, B.C., et al. (2014, July). Nicotinamide enhances repair of ultraviolet radiation-induced DNA damage in primary melanocytes. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24798949/

Navarrete-Solís, J., et al. (2011, July 21). A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21822427/

    Here’s How to Get Rid of Milia Effectively (Don’t Pick Them)

    They’re not pimples, so save your benzoyl peroxide for your next breakout. Though milia look kind of like whiteheads, they’re not the same thing, so they require different treatment.

    The good news is: milia are usually painless and don’t reflect an underlying health concern. They usually go away on their own in a few months but can be stubborn and stick around for years. Whether you’ve got persistent milia that won’t go away or you just want clear skin fast, it’s easy to get rid of milia and prevent them from coming back with a few tweaks to your skincare routine. For treatment, consider tretinoin for milia, adding a gentle chemical exfoliant to your routine, or going to a derm to get them extracted. For prevention, that exfoliant can help keep milia at bay but don’t forget the sunscreen, too.

    WHAT CAUSES MILIA? (AND WHAT ARE THEY?)

    Milia are small, white or yellowish cysts that commonly appear on the skin. Milia pop up when dead skin cells become trapped near the surface of the skin, forming small cysts that are often visible on the face. While they may resemble whiteheads, milia are distinct and do not have an opening, making them difficult to extract through typical means. Although milia are generally benign and painless, it’s natural to want to remove them.

    Most milia in adults are random and don’t have an underlying condition Certain factors can block the skin’s ability to exfoliate dead skin cells and sebum like it’s supposed to.Let’s take a closer look at the two types: primary and secondary. Note: which kind you have doesn’t really matter; you can treat primary and secondary milia the same way.

    PRIMARY MILIA

    Primary milia are a result of blocked hair follicles or sweat ducts. Unlike secondary milia, primary milia are typically associated with normal skin development and are not indicative of an underlying health issue. These tiny cysts contain keratin, a protein found in the skin, and can be found on various areas of the face, particularly around the eyes, nose, and cheeks. While primary milia often resolve on their own over time, consulting with a dermatologist for personalized advice and treatment options is recommended for efficiency and safety.

    SECONDARY MILIA

    Secondary milia develop as a consequence of skin trauma, certain skin conditions, or as a reaction to certain products. They are often associated with factors such as blistering, burns, or inflammatory skin disorders. These cysts can appear in areas where the skin has experienced damage or trauma, and they may contain trapped debris or keratin. While secondary milia share a similar appearance to primary milia, addressing the underlying cause of the skin condition is needed in order to treat them.Talk to your dermo for proper diagnosis, management, and potential removal, as they can persist without appropriate intervention.

    OTHER CONDITIONS THAT CAUSE WHITE BUMPS

    White bumps on the skin may not always be attributed to milia alone; several other skin conditions share a similar appearance, and proper identification is crucial for effective treatment. These may include clogged pores, a result of trapped oils and dead skin cells; overgrown oil glands, which can lead to the formation of small, white or flesh-colored bumps; sebaceous cysts, sack-like structures beneath the skin's surface; seborrheic keratoses, often described as clay-like blobs adhering to the skin; actinic keratoses, characterized by crusty and hard skin bumps; xanthelasma, irregularly shaped bumps commonly found around the eyes or eyelids; or, in rare cases,skin cancer. 

    Given the variety of potential causes for white bumps, it is essential not to self-diagnose. If in doubt, seeking professional advice through a dermatologist check-up is the best course of action to rule out other possibilities and determine the most suitable treatment approach based on the specific skin condition present.

    HOW TO PREVENT MILIA

    While they are generally harmless, milia can be annoying to deal with. Maintain good skincare habits and use products like Tretinoin to prevent milia.

    1. EXFOLIATE

    Dead skin cells can accumulate on the skin's surface, leading to blockages in hair follicles. To counteract this, it is recommended to use a gentle exfoliating scrub or cleanser containing alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs). AHAs, such as glycolic acid and lactic acid, work to slough off dead skin cells from the skin's surface, promoting a smoother complexion and preventing the buildup that can contribute to milia. BHAs, such as salicylic acid, are oil-soluble and can penetrate deeper into the pores, helping to unclog them and reduce the likelihood of milia formation. Regular use of these exfoliating ingredients promotes healthy cell turnover, keeping the skin clear, vibrant, and less prone to the development of milia. It's important, however, to avoid excessive exfoliation, as this can lead to irritation and compromise the skin's natural barrier. Incorporating exfoliation into a balanced skincare routine can contribute to a healthier complexion overall.

          2. OPT FOR OIL-FREE PRODUCTS

    Selecting the right skincare products is essential in preventing the formation of milia. Tretinoin is particularly powerful for milia prevention (check out full Tretinoin cream benefits in our blog post). Opting for non-comedogenic and oil-free formulations is crucial because these products are specifically designed not to clog pores, reducing the risk of milia development. Non-comedogenic products are formulated to be lightweight and less likely to cause blockages in the hair follicles, helping to maintain clear skin. It's particularly important to be cautious in areas prone to milia, such as around the eyes and on the cheeks. Heavy, pore-clogging creams or moisturizers can exacerbate the issue - they may create an environment where dead skin cells and oil accumulate, leading to the formation of milia. Instead, you should choose products labeled as non-comedogenic, oil-free, or formulated for sensitive skin, as these are less likely to contribute to pore blockages and can help maintain a healthy, blemish-free complexion. If you’re using a retinoid like retinol, learn if you should use retinol before or after moisturizer with our guide. 

         3. USE SUNSCREEN DAILY

    Sun damage can cause milia, so develop a skincare routine that protects against sun exposure. The sun’s rays are responsible for up to 80% of external skin damage 1, so to prevent milia, sunscreen should be at the top of your list. Opt for a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or higher, as it provides defense against both UVA and UVB rays. Applying sunscreen diligently before stepping out into the sun forms a formidable barrier, shielding your skin from the potential harm that could lead to milia. Regular reapplication every two hours, especially during prolonged sun exposure, is essential to maintain its effectiveness. A consistent commitment to sun protection not only aids in preventing milia but also contributes to the overall health and longevity of your skin, reducing the risk of sun-induced damage and premature aging.

    HOW TO REMOVE MILIA

    Milia treatment is pretty simple. Use these derm-approved tips to reduce milia and prevent them from coming back. Removing milia at home can lead to further skin irritation or infection, so it’s always best to discuss with your dermo before you attempt any home treatment. Your dermo will often recommend Tretinoin for milia treatment

    1. AVOID PICKING AT THEM OR TRYING TO POP THEM

    You should never pick or attempt to extract milia at home due to the potential risks and complications it can entail. Milia often occur beneath the skin's surface, and they require careful and precise extraction methods best performed by dermatologists. Trying to pick or squeeze milia at home may lead to skin irritation, inflammation, and an increased risk of infection. Additionally, improper extraction can cause scarring, hyperpigmentation, or further blockages in the pores, exacerbating the issue. It is crucial to exercise patience and seek professional guidance from a dermatologist for safe and effective removal of milia. Dermatologists have the expertise, sterile tools, and controlled environments necessary to perform extractions without compromising skin health.

    2. USE A GENTLE EXFOLIATOR

    Give skin that isn’t exfoliating like it’s supposed to a little help with a non-irritating exfoliant. Adding an exfoliant to your skincare routine can help usher out the buildup of keratin, dead skin cells, and oil while minimizing irritation.

    Skip the facial scrub, though. According to dermatologist Dr. Sheila Krishna, physical exfoliation can be irritating, causing more oil production and scarring. A physical exfoliant only deals with the surface of the skin anyways. Instead, go for a gentle chemical exfoliant like AHAs, BHAs, or topical retinoids (aka vitamin A derivatives). There are many studies proving the efficacy of tretinoin for milia.

    Chemical Exfoilants

    Chemical exfoliants will penetrate the skin and draw out the buildup causing your milia. Now you might be thinking, “What if I have milia around my eyes? Aren’t I supposed to avoid these types of products around my eyes?” You’re right! Please avoid the delicate eye area when applying chemical exfoliants. But according to dermatologist Dr. Lana Kashlan, these products “will spread locally beyond the area of direct application.” So when you apply chemical exfoliants to the rest of your face, they’ll diffuse under the skin and work to minimize your milia.

    Include chemical exfoliants as part of your regular skincare routine as well to prevent milia from coming back.

    3. CONSIDER IN-OFFICE TREATMENTS FROM YOUR DERMATOLOGIST

    If at-home treatment isn’t working to get rid of your milia, ask your dermatologist about the in-office treatments they offer. In-office treatments can be more expensive than at-home remedies, so keep that in mind to find the right balance of effectiveness, treatment speed, and budget for you. In-office treatments are also worth considering for milia on the eyelids or right next to your eyes. You don’t want to risk getting skincare products in your eyes.

    Deroofing

    Deroofing is a common extraction method for milia. It involves cutting the milium cyst (one milia) open with a sterile needle or knife and removing the cyst with an extraction tool. This procedure is easy for derms but can be dangerous to try at home, so don’t do it yourself.

    Cryotherapy

    Cryotherapy, a technique involving the application of extreme cold, is sometimes used for milia removal. Done by a dermo, the freezing process causes the milia to blister and eventually slough off, revealing smoother skin beneath. Cryotherapy is considered a quick and relatively non-invasive procedure. 

    Laser Treatments

    Laser treatment is another option for milia removal, particularly when other methods are ineffective or if the milia are persistent. Laser therapy for milia involves using a focused beam of light to target and break down the keratin deposits that make up the milia. The laser energy is absorbed by the milia, promoting their disintegration and eventual absorption by the body. This non-invasive procedure is generally well-tolerated and can be performed in a dermatologist's office. Multiple sessions may be required for optimal results, depending on the size and quantity of milia.

     

    HOW TO USE TRETINOIN FOR MILIA

    Now that you know your options, it’s up to you to decide which route to take to get rid of milia. If you opt for a topical retinoid, consider getting a dermatology-grade retinoid like Tretinoin or adapalene for milia. You can compare adapalene vs Tretinoin in our blog post.. Derm-grade retinoids are more potent than over-the-counter retinol. By getting a prescription, you can better tailor your skincare routine to your skin needs.

    That’s where Dear Brightly comes in. After sharing your skin story, a board-certified provider will determine whether to prescribe you a retinoid serum and the right concentration for your skin. Then, you’ll be sent Night Shift—your dermatologist-formulated tretinoin prescription online —in the mail. It’s the ease of an online doctor’s consultation from the comfort of your home without the cost or bother of an in-person visit.

    Tretinoin has emerged as an effective treatment for milia. It works by accelerating cell turnover, preventing the accumulation of dead skin cells, and promoting the shedding of keratin. When applied as directed by a dermatologist, Tretinoin not only aids in the removal of existing milia but also prevents repeat outbreaks.

    Sensitive skin or retinoid rookie? Depending on your skin and skin history, your provider may start you on a lower strength retinoid serum before increasing to the concentration that’s ideal for your skin. This will minimize irritation and give your skin a chance to adapt to increased skin cell turnover.

    Night Shift is formulated with Tretinoin, the only FDA-approved retinoid for photoaging and acne with over 50 years of research to prove its safety and efficacy. It’s 20 times more potent than over-the-counter retinol, so it shows results faster.

      How to Get Rid of Whiteheads the Easy Way, According to Dermatologists

      We’ve all woken up to find a freshly formed pimple staring back at us in the mirror. Our first instinct is to pop it or scrub it away. But both methods can damage our skin and make whiteheads worse.

      Whiteheads (also called closed comedones) are a type of acne that forms when sebum (oil) and dead skin cells build up around a hair follicle. The skin cells get stuck in the pore instead of exfoliating like they’re supposed to, forming white bumps under the skin’s surface. If you leave a whitehead for too long without treating it, it becomes a breeding ground for bacteria and can become red and inflamed.

      So it’s best to nip those zits in the bud with effective treatments recommended by the derms. We talked to board-certified dermatologists Dr. Lana Kashlan and Dr. Sheila Krishna to find out how to get rid of whiteheads.

      Their recommendation? Retinoids. And to keep whiteheads from coming back, good skin habits are key. That boils down to keeping your face—and the things that touch it—clean.

      1. Use dermatologist-approved treatments to get rid of whiteheads

      Whiteheads can be persistent, and the wrong treatments can make skin conditions worse. You want to use acne treatment methods that not only work but will make your skin healthy and less prone to acne.

      Retinoids

      Topical retinoids (aka vitamin A derivatives) are usually seen as wrinkle smoothers, but they’re superstar acne fighters too. Dr. Kashlan and Dr. Krishna praise retinoids as the number one treatment for whiteheads.

      But be choosy with your retinoid: An over-the-counter retinol won’t help you reach your goals. Dr. Kashlan warns, “Retinols really don’t do anything for acne.” So when adding a retinoid to your whitehead regimen, go for a more potent dermatology-grade retinoid. Dr. Krishna recommends, “Specifically, things like tretinoin or even something like adapalene . . . these can all work to exfoliate the skin gently and get rid of the trapped oil and skin cells.”

      Retinoids also make oil glands smaller and increase collagen production, which lowers oil production and causes less buildup.

      Extractions

      Extractions aren’t something you want to DIY to remove whiteheads. But getting them extracted by a dermatologist is worth considering for deep whiteheads. “If the whiteheads are very deep,” says Dr. Kashlan, they “may require a visit to a dermatologist to help express them from the surface.”

      But in general, she warns, “They’ll just refill.” You’re not treating the root cause of the whiteheads: sticky skin cells clogging the pores.

      “You have to a have a retinoid on board,” Dr. Kashlan continues, “in order to reprogram the skin cells.” By reprogramming the skin cells, you teach them to be less sticky. So when it’s time for dead skin cells to shed, they exfoliate like they’re supposed to instead of sticking around and causing pore buildup.

      While extraction is a good way to get rid of deep whiteheads, a proper skincare routine that includes a gentle face wash, moisturizer, and retinoid (e.g., tretinoin, adapalene) is generally the best way to treat whiteheads and prevent them from coming back.

      2. Avoid methods that could make skin problems worse

      Don’t pop them

      We’ve all picked at pesky whiteheads, trying to get them to go away. But Dr. Kashlan recommends against that. “It tends to cause scarring, irritation, and makes them look worse.” Basically, you’ll be left with other skin issues that need treatment, too.

      Pass on the facial scrubs

      Think twice before you pick up a facial scrub or another physical exfoliant like coffee grounds or sugar. Dr. Krishna says, “These products can actually serve to irritate the skin, cause more oil production, or even leave scars and marks on the skin.” So they’re not really helping the situation.

      Instead, Dr. Krishna recommends sticking to a good skincare routine with a chemical exfoliant that can penetrate the skin and gently draw out pore buildup instead of scrubbing.

      Skip the clay or peel-off face masks

      Those clay masks and peel-off masks aren’t going to do what you want them to either.

      Clay masks are supposed to draw oil out of the skin, but Dr. Krishna says, “It does start to draw the oil out, but…doesn’t do it all the way…all that oil gets stuck, and it doesn’t actually end up coming out.” So by using a clay mask, you could end up with a bad acne breakout and need antibiotic treatment. Plus, clay masks can irritate the skin.

      Dr. Kashlan adds that those black peel-off masks that claim to treat blackheads and whiteheads are no good either. She says, “You can damage the skin surface.” So stick with gentler methods for treating whiteheads.

      Steer clear of home steaming

      Dr. Kashlan warns against home steaming for getting rid of whiteheads. “You can cause burns from the steam that can be dangerous,” she says.

      The best path forward to get rid of whiteheads is to use a retinoid or go to a derm for an extraction. Then, keep whiteheads at bay with a consistent daily skincare routine.

      3. Prevent whiteheads from coming back with good skincare habits

      Now, it’s time to develop the right skincare habits to keep those whiteheads from coming back.

      Use a derm-grade retinoid to get rid of whiteheads

      The most effective retinoid can’t be found at a store. To get rid of whiteheads effectively, you’ll want a dermatologist-grade retinoid that can pack a punch.

      Tretinoin is a prescription retinoid that’s 20 times more potent than over-the-counter retinol1 and has over 50 years of research to back up its safety and efficacy, including for whiteheads2. And now, it’s easier than ever to get a doctor’s consult for tretinoin from the comfort of your home.

      Night Shift is a tretinoin serum formulated by dermatologists and tailored to your skin by doctors online. After sharing your skin story, a provider will determine the best concentration of tretinoin to reach your skin goals. They’ll write a prescription if applicable. Then, your tailored retinoid serum will be delivered in the mail.

      Retinoid newbie or sensitive skin? Your provider may ease you onto retinoids with a lower-strength serum to start, then increase to the full strength that’s ideal for your skin over time. So you’ll have a chance to adapt to your new formula.

      Finding the right skincare can be overwhelming, but we’re here to help! Feel free to email us if you ever have any questions.


      1. Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
      2. Latter, G., et al. (2019, October). Targeted Topical Delivery of Retinoids in the Management of Acne Vulgaris: Current Formulations and Novel Delivery Systems. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835300/

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