How to prevent Melasma
If your estrogen rises, due to pregnancy or taking the pill, there’s a good chance you could develop Melasma. The single best way to prevent it is by staying out of the sun (and tanning booths) completely. The second best way is to wear a good sunscreen at all times – even if you leave the house for only 5 minutes to run an errand. Zinc Oxide based sunscreens are the absolute best for protecting your skin from the sun, and I write in depth about Zinc Oxide sunscreens here. I would recommend a sunscreen with at least 10% Zinc Oxide, and at least SPF 30 at all times! Make sure to reapply if you are outdoors for more than a few hours, and reapply after swimming or sweating. Unfortunately, Melasma can happen quickly, and just one day of sun exposure without a good sunscreen can cause it. Once you get Melasma, it’s difficult to get rid of, at least quickly, so protection is by far your most important measure.

How to get rid of Melasma
If you are pregnant, you don’t want to be doing professional skin care treatments, or using most prescription skin products, nor do you want to use a product with Hydroquinone as an active ingredient. Luckily Zinc Oxide is safe to use while pregnant. DermaDoctor has an informative article that talks about Melasma in detail. There are several topical options to treat Melasma, and they are supposed to be applied just to the dark patches, not to your whole face. That way you are just lightening the dark areas, rather than lightening your whole face. Unfortunately, it’s not easy to apply a cream just to small areas of your skin, at least from my own experience.

Hydroquinone, a skin lightener, is the most common used ingredient for Melasma, and sun spots. It has elicited some controversy, because a lot of people claim it can be hazardous. Ironically, it can make you more sun-sensitive, so if you are not staying out of the sun, you can make your Melasma worse! I am not sure what to believe about the safety of Hydroquinone, but a lot of reputable skin care companies still use the ingredient. Glycolic Acid, and Tretinoin, or Retinol are also used by themselves, or in combination, to treat Melasma. Kojic acid, Azelaic acid, Licorice extract, Salicylic acid and Vitamin C are also ingredients that can possibly lighten your dark patches.

My experience with Melasma
I’ve had Melasma just around my mouth area, which I got from being on the pill (to treat acne). Oh the irony! I have also had sun spots or freckles, which are from sun damage, not from hormonal fluctuations. I’ve tried gels with Hydroquinone and Salicylic acid, and didn’t see any results. I had small tiny patches of Melasma, so it’s hard to just put the gel on that tiny area. When I went off the pill, my Melasma went away. When I went back on it, I was using a good Zinc Oxide sunscreen and avoiding the sun, so I didn’t have much Melasma surface this time around.

Photo Facials for Melasma?
Photo Facials, or lasers used to lighten dark spots work well on sun damage. However, at the Medical Spa I worked at, the Estheticians said they saw poor results when treating Melasma. So I would consult a Dermatologist to see if lasers would or wouldn’t be an option for Melasma. In the mean time, it’s not easy to treat Melasma quickly, so stay out of the sun!!!

Related posts:

1. Hydroquinone Update
2. Hydroquinone, The Skin Lightener
3. Ambi Skin Care Fade Cream

Brevicon
Cyclessa
Demulen 1/50
Diane-35 (not sold in US)
Mircette
Modicon
Necon
Ortho Evra (the patch)
Ortho-Cyclen
Ortho Tri-Cyclen
Yasmin

Based on this premise, here is a list of pills that can make acne worse:

Depo-Provera (shot)
Loestrin 1.5/30
Loestrin 1/20 Fe
Estrostep Fe
Levlen
Alesse
Ovral
Norlestrin

There are lots of other birth control pills out there, all of which address different concerns such as weight gain, depression, PMDD, and break-through bleeding. There are some that sort of fall in between these two extremes of being good vs. bad for acne, which is why I didn’t include them here. Also, I typed up this list about two years ago, so I’m not sure if there are any new pills on the market I’ve missed. The only ones I know about are Yaz and Ortho Tri-Cyclen Lo, and they are both lower than 30mcmg in Estrogen. There’s also Seasonale, but I wasn’t able to determine from their website its hormonal composition. Also keep in mind that everyone has a different level of hormones that is natural to their body, so The Pill is going to effect everyone differently. Before deciding on going on The Pill, read up on it and weigh your decision carefully, because it can have serious side effects, so it’s not for everyone, especially smokers.

If you don’t want to go on The Pill, there’s a pill that is similar to Yasmin, in that it’s an anti-Androgen pill, but it’s not an oral contraceptive. Spironolactone is a water pill (diuretic) that helps with water retention and high blood pressure, but it’s also had success in helping with hormonal acne. One final note: The Pill can make you more photo sensitive. Thus, you should always wear sunscreen or you may end up burning more easily, or you could develop Melasma (skin hyperpigmentation)!!! Let me know your pill stories and how it’s effected your acne!

Related posts:

1. How I Cured My Adult Hormonal Acne
2. Guide to Cure Acne
3. Acne Treatments That Didn’t Work

The new Dermatologist switched me from Differin cream to Differin gel, and I don’t know if that made any difference or not. Random note: I use the .1% Differin, but notice they now have a stronger .3% version. Interesting. Well the good thing about Differin is that is has NO side effects on me at all. It doesn’t dry out my face or make it oily. It’s expensive, though. Oh, yeah, and so is the Yasmin, since there’s no generic for it, but it’s worth it!!!! At the same time, I had just finished reading Don’t Go To The Cosmetics Counter Without Me – Paula Begoun which talks about all of the major skin care products on the market. The book helped me narrow down which products were worth using (for acne and for wrinkles), and it taught me even more about what actually works for your skin, and what is crap (a lot of products!) You should check out Paula’s website: Cosmetics Cop. Also at the same time, I found the fabulous MakeupAlley which lists products and has viewer reviews. It’s extremely helpful to see what “real” people have to say about products, and whether or not they work or cause their skin to breakout, etc. Finally, the last key to my product research came when I discovered several websites that listed product ingredients that can cause your pores to clog and your skin to breakout. I will make a separate post about these sites and the ingredients because it’s a long list! So guess what, almost EVERY single moisturizer or acne product I owned contained ingredients that were alleged huge pore cloggers! WTF? It turns out (from my estimate) 75% of the products on the market will possibly clog your pores, if you are acne-prone. Even acne products, and non-comodogenic, oil-free products contain these ingredients! Why? So that you will mess up your skin even more and buy more products?? I don’t know. Also, a lot of the acne products I used dried out my skin even more, making me need even more moisturizer, and making the acne worse.

Here is the “acne safe” morning regimen I follow:
- Wash my face with Philosophy Purity Made Simple cleanser. This is a great cleanser because it hydrates as it cleanses, so my skin doesn’t feel parched. If I travel to somewhere humid, I use Neutrogena Healthy Skin Anti-Wrinkle Anti-Blemish, which is a little more drying.
- Apply Paula’s Choice Skin Recovery Super Antioxidant Concentrate or Olay Regenerist Deep Hydration Regenerating Cream. Sometimes I mix in a pinch of Philosophy Hope And A Prayer topical Vitamin C powder. I need antioxidants, and peptides to fight against wrinkles!
- Apply Clinique Moisture On-line. Remember I live in Vegas and have super dry skin. When I go to Hawaii, or somewhere else humid, I don’t need as much moisture!
- Mix Shiseido Ultimate Sun Protection Cream For Face – SPF 55 with Maybelline Pure Makeup Nude (nude). I know I am diluting the sunscreen, and I need to research how much this effects its SPF.
- Put on Maybelline Instand Age Rewind Under Eye Concealer (medium) on any spots (I’m not crazy about this concealer, but it’s fine), and then put on Neutrogena Healthy Skin Pressed Powder (medium) with a powder brush. It’s a very light, non-cakey powder.

Here’s my night regimen:
- Use the same cleansers as the morning.
- Apply Differin .1% gel. I used to rotate this with TxSystems Afirm 3x, a strong retinol, but it’s drying, so it sometimes makes my face flaky. I am pretty sure the Differin also works similarly to Retin-A as a wrinkle-reducer/preventor, but I haven’t found any studies comparing the effectiveness of Differin to Retin-A.
- Apply Dove Energy Glow Night Cream. Sometimes I use Burt’s Bees Marshmallow Vanishing Creme, but I think it clogs my pores, so I just use it around my eyes. I don’t love these creams, but haven’t found anything better.

Specialty products:
- If I feel a breakout is coming, I’ll use Paula’s Choice 2% Beta Hydroxy Acid Gel in the morning, instead of the antioxidant serum. Paula says that Salicyclic Acid needs to be at the proper ph level to work, and supposedly a lot of products are not effective because of the wrong ph.
- If I do get the rare pimple, I’ll dab it with Paula’s Choice Blemish Fighting Solution and TxSystems Afirm 3x.
- Once a week I use the fabulous Philosophy The Microdelivery Peel. Even though the Differin keeps my skin exfoliated, this is gentle enough that it makes my skin look great, and it’s not irritating at all
- When my face feels especially dry, I’ll use Paula’s Choice Skin Recovery Treatment Mask.

Other things I do to help my skin include washing my face with lukewarm water (no hot water or ice on pimples – FU The Acne Cure book). Then I bought a big pack of washcloths at Target and use a new washcloth every day to very gently pat my skin dry after washing. And from Wal-Mart of all places, I found some fabulous satin (well 100% poly) pillowcases that I make sure to change often. These leave you with no wrinkles on your face in the morning, and they are good for your hair!

After three months of this regimen, I was acne-free (and my skin wasn’t super flaky anymore), and I still am two years later! That’s my “after” picture in this post. I do not believe my acne would be gone if I didn’t do all of the things I do – the pill, the non-pore clogging products, and probably the Differin (I don’t know if it “really” works, but I’m afraid to not use it at the same time). For women that have hormonal acne who don’t want to take the pill (or Accutane) I honestly don’t know what to do to be acne-free. Maybe acne laser treatments (oh yet another post). Also, aside from the Differin, I don’t think the products I use help my acne as much as they don’t make it worse. Once my acne went away, I was left with about 50 red spots where the acne used to be. Luckily I only got one actual scar during the whole process. The saga of the red spots will be left for another post as well. And the saga of the blackheads on my nose will also be left for later.

Related posts:

1. The Pill To Treat Hormonal Acne?
2. Avoid Cosmetic Cornstarch If You’re Acne-Prone
3. Guide to Cure Acne