‘Do you have recommended ways to get rid of pigmentation?’

‘Do you have recommended ways to get rid of pigmentation?’ -@simi27 👩🏻‍⚕️#askdrnatalia

Yes! ✨

The most important thing first is to get the diagnosis right and establish the underlying cause (because what’s the point of treating pigmentation if it’s just going to come back, right?).

Once that’s established, then the best course of action can take place. Almost always I start with a good prescription topical depigmenting cream combined with a high-quality prescription retinoid.

Along with vigilant sun avoidance (so that’s a wide brimmed hat and sunnies all the time when you go outside during the day) and the use of a 100% mineral sunscreen every single day.

After the first few weeks of nighttime treatment, I sometimes add in a morning prescription cream as well because the clinical evidence shows best results for certain types of pigmentation problems comes from twice daily application for at least 3 months. Depending on the diagnosis, I might also add in an oral tablet for a few months but that totally depends on the patient. Because I get such great results from topical prescription creams, I rarely use any laser or light treatments.

Also these types of treatments can potentially make pigmentation worse. I also would not recommend any physical treatments like dermapen or microneedling as these things can also worsen pigmentation. Once the pigmentation is cleared, the most important thing is maintenance treatment to keep the pigmentation away for good – and that is normally a slightly weaker strength of what we used to clear it. I use compounding labs both in the UK and Dubai to create these prescription products for my patients.

I have just rewritten a suggested protocol for the management of melasma based on clinical trials over the past 10 years and it will be published soon in the Journal of Cosmetic Dermatology so watch this space!