By April Segal, PharmD, BCPS, APh

As summer starts ramping up, we want to make sure you have what you need to feel protected and confident! Skin damage specifically caused by sun exposure is called photoaging and accounts for over 80% of skin aging. Photoaging causes the skin to look older, wrinkled and rough, or speckled with dark spots. 

So how does the sun cause this damage? UV radiation from the sun causes erythema and reduces the number of dermal blood vessels that supply nutrients to the skin. This  UV radiation also generates oxidants and creates damaged keratinocytes called "sunburn cells”. Sunlight also damages collagen and elastin, which are important for maintaining skin tone and texture. Previously we have talked about supplements you can take orally to help prevent or treat skin damage. Check out that article here if you missed it. 

Today we are going to discuss some topical options that are available at Remedy and also custom prescription formulas we compound frequently.

Antioxidants

A popular approach to addressing aging skin is to use antioxidants to prevent the oxidative damage caused by sun exposure and UV radiation. Vitamin C is one of the most common antioxidants included in skincare products. In addition to its antioxidant effects against UVA-induced oxidative damage, vitamin C is thought to play a role in collagen synthesis and tissue repair. One downside is that vitamin C is water-soluble and therefore, taking it orally might not produce high enough concentrations in the skin to be beneficial. There is evidence that shows vitamin C applied topically is more effective. We love our CA- local brand Agent Nateur’s dehydrated Holi (c) powder. This powder can be dissolved in any topical serum or lotion just prior to application. Because water can interact with vitamin C and cause it to degrade, by keeping it in this powdered form up until the point you are ready to apply, you get the most potent Vitamin C antioxidant activity possible! Yay Science!

Compounded Prescription Lightening Creams

If you want to take your skin regimen to the next level, you may seek out a dermatologist for more extensive treatment options including peels, lasers or topical medication options that can help. One of our most popular compounded products is a skin “lightening” or “bleaching” cream formulated by Dr. Seaver Soon, Dermatologist and founder of the Skin Clinic MD. Dr. Soon explains “I use compounded medications for hyperpigmentation because it allows me to combine multiple active ingredients that address the problem in different ways, thus increasing effectiveness. Being able to adjust the concentrations based on what each patient needs allows me to tailor the medication to the needs for each individual”. Check out the top ingredients Dr. Soon likes to combine:

• Kojic Acid- Interestingly, this ingredient is made from a variety of fermented fungi that work to interact with your skin’s overall melanin production. Melanin is the skin pigmentation that colors your skin, hair, and even your eyes, and it relies on the tyrosine amino acid to continue to produce this melanin. Kojic acid is actually able to stop the production of tyrosine in the skin, which means that melanin production also slows down. This means lighter skin, a reduction in the appearance of scars, and even a few anti-aging benefits. Many women who suffer from melasma — when the skin darkens during pregnancy — also rely on kojic acid to help lighten their skin. When using a kojic acid cream or serum, just make sure to limit your time in the sun and to wear sunscreen whenever you’re outside.

• Hydroquinone- In addition to helping to lighten your skin, hydroquinone can also reduce the appearance of freckles, age spots, hyperpigmentation, and liver spots. As with kojic acid, hydroquinone also works to stop production of tyrosinase, but it also breaks down the melanocytes and melanosomes responsible for hyperpigmentation and patches of discoloration on the skin. Most people who use hydroquinone say that they begin to see results in as little as four weeks. Commercially, hydroquinone is available in a concentration of 4%. Dermatologists often write for compounded prescriptions that involve higher concentrations. It is not uncommon to see hydroquinone in combination with kojic acid as synergy provides for a much stronger bleaching regimen that is often used in more severe cases and melasma. Just make sure that, when using hydroquinone, you stop using hydrogen peroxide and benzoyl peroxide over the course of your treatment.

• Tretinoin- Also called Retin-A, tretinoin is one of the most commonly prescribed skin bleaching products on the market today. Topical retinoids increase epidermal turnover, thereby facilitating melanin dispersion and removal.

• Ascorbic Acid- A form of potent vitamin C, with antioxidant properties as discussed above.

• Hydrocortisone- This ingredient inhibits melanin synthesis but also can help reduce irritation that can be caused by some of the active ingredients above like tretinoin or hydroquinone. This allows patients to be able to tolerate higher more effective concentrations.

We are happy to answer any and all of your skincare questions! Please stop by and talk to our knowledgeable pharmacists and herbalists.