Suggest skincare routine for 45 year old with freckles/age spots and some acne

[Anonymous]

I use a combination of Musely and Curology. Musely has a 12% hydroquinone product that you can use for up to 6 months, now I am using the HQ free version. The Curology has Tretinoin, Azelaic Acid, Clindamycin.

I found the derm somewhat useless for hormonal acne. The Curology was an amazing difference than all the regular products, like plain Retin A, Differin, etc. I had breakouts constantly after age 42--Since I've been on Curology I've had like 3 zits in 1.5 years.

I did try Triluma but it is expensive and needs to be refrigerated. I could also only use it a few times a week because I would peel if used it on consecutive nights. It was effective though.

I use Avene products for moisturizer and cleansing.

[Anonymous]

I’d switch your face wash from Cetaphil to CeraVe. Better ingredients.

- Vitamin C + moisturizer + sunscreen in the morning
- Retinol or chemical exfoliant (AHA/BHA) in the evening + moisturizer + face oil

[Anonymous]

Anonymous wrote:

Anonymous wrote:Bump up your SPF to 50 especially because you have freckles and pale skin.

This! SPF 18 is not high enough. You need at least 30 spf and need to apply at least twice throughout the day. This is the most important thing you can do for your skin. Every day, even if you are indoors.

I'd also recommend getting tretinoin (Retin A). It will help with acne and anti-aging.

If you normally (not during pandemic) have a job outside the home, how do you do this? Do you wash your face at work and re-do your makeup? Seems really impractical to me.
I use Elta MD, followed by Laura Mercier tinted moisturizer/sunscreen in the AM and with a light dusting of face powder. I have the ColorScience facepowder/brush with SPF that I'll use throughout the day, but it's certainly not "reapplying" sunscreen.

[Anonymous]

Anonymous wrote:Hi OP - I have skin much like yours, and here is what I use (including what my derm prescribed)

Morning
Wash with neutrogena foaming wash
Sunday Riley CEO vitamin C
Hydroquinone for dark spots
Drunk elephant B hydra
Ole Henrikson Banana Bright
Dapsone for hormonal acne
DRMTLY sunscreen

Night
Neutrogena foaming wash
Drunk elephant F balm electrolyte mask
Adapalene for aging/acne
2x a week I use a glycolic instead - Paula’s choice 8% AHA

It’s taken me years of trying different products and working with my derm to get the right mix and strength for everything - definitely ask your doctor about the hormonal acne!

This is crazy. I also have this skin and it’s not a part time job.

OP skip the crazy creams for spots. They simply do not work. Get IPL or other laser treatment at your doc. It’s the only thing Harold work and it’ll work instantly.

Wash + vit C serum + spf moisturizer in am

Wash + retin A + heavy moisturizer in pm.

[Anonymous]

Anonymous wrote:

Anonymous wrote:For the age spots, get an appointment for IPL and have them lasered off. I'm in my 50s and it done the first time in my mid-40s and again when I was in my early 50s. I'll do it again after the pandemic. I'm really fair with rosacea and the IPL did an amazing job getting rid of the sun spots.

How many times did it take? I tried prescription hydroquinone (triluma) and it didn’t work at all for age spots.

PP here. After the first session, I noticed patches darkening and sloughing off. By the 3rd visit (you go 3-5 times over a 3-5 month period), my complexion was really clean/clear. My 80 yo mother has also had it done and her results aren't as good as mine but was still noticeably improved.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Bump up your SPF to 50 especially because you have freckles and pale skin.

This! SPF 18 is not high enough. You need at least 30 spf and need to apply at least twice throughout the day. This is the most important thing you can do for your skin. Every day, even if you are indoors.

I'd also recommend getting tretinoin (Retin A). It will help with acne and anti-aging.

If you normally (not during pandemic) have a job outside the home, how do you do this? Do you wash your face at work and re-do your makeup? Seems really impractical to me.
I use Elta MD, followed by Laura Mercier tinted moisturizer/sunscreen in the AM and with a light dusting of face powder. I have the ColorScience facepowder/brush with SPF that I'll use throughout the day, but it's certainly not "reapplying" sunscreen.

I'm not PP but actually yes that's exactly how I would describe the use of Colorescience SPF powder, "reapplying sunscreen." (I use it too.)

[Anonymous]

It took prescription topicals for me to combat hormonal acne. You may need to consult with the dermatologist first to get a handle on that, and then see what additional anti aging and other skin products (serums, moisturizers, glycolic acids etc) work alongside those topicals and what your skin can tolerate.

Combat the acne first.

[Anonymous]

I have a whole routine that is similar to PPs:

AM
-wash with Dermalogical dermal clay cleanser (which sadly I think has been discontinued but I just found at Walmart online)
-exfoliate with Dermalogica daily resurfacer leave on face exfoliator
-either Skinceuticals CE Ferulic or Blemish & Age Defence (salicylic acid)
-I let that dry & then use either in house moisturizer from my dermatologist (Tamjidi Skin Institute, you can get it online) or Skinceuticals HA intensifier (hyaluronic acid) or Kiehl's midnight recovery oil, depending on how dry my skin is
-I only use this sunscreen: EltaMD UV Clear Facial Sunscreen Broad-Spectrum SPF 46 for Sensitive or Acne-Prone Skin (they make another one that doesn't work for me)

PM
wash with Dermalogica dermal clay cleanser (NOT their new active clay cleanser which I intensely dislike) if I haven't been wearing makeup, with Tatcha The Deep Cleanse Gentle Exfoliating Cleanser if I have
-if I have a fair amount of time before I go to bed I will moisturize with one of the above products
-before bed I put on (prescription) Avar & Soolantra (mix) for rosacea/acne

BUT the most important factor in all of my skin care is that I take spironolactone thanks to DCUM.

[Anonymous]

Age spots and discoloration are a very common problem in women of childbearing age. Sun exposure, hormones, sebum within the skin, inflammation, and diet can all cause changes in the texture, color, and complexion of the skin. Melasma is a very prevalent skin discoloration problem that is usually caused by hormones. When considering options, you should opt for proven skin lightening agents that can reduce the abnormal production of melanin. Dermatologists like to control discoloration with exfoliation and tyrosinase inhibitors. I usually recommend Melarase AM and Melarase PM because they are physician-developed and they do not contain high concentrations of Hydroquinone like the prescription versions of Musely and Curology. Exfoliate with a pre-soaked alpha beta pad daily and use a retinoid at night. All of these options will improve your complexion and reduce discoloration.

[Anonymous]

Anonymous wrote:OP here with one more question: where do you recommend I go to get these questions answered? My dermatologist checks moles and stuff, but she didn't recommend any products in particular. Seeing someone in person might be a post-pandemic activity, but I don't know where to start!

You have to book the appointment as a skin care consult. A skin check is a different type of appointment. I’ve been to several dermatologists and most of them aren’t cooperative if you start it as a skin check and then start asking for anti aging or acne products because they have a certain time period allocated for the skin check and you are running the appointment longer. Does that make sense? It doesn’t mean you are going to the wrong doctor, just that you have to let the front desk know in advance.

[Anonymous]

Try cutting out sugar (even fruit - mango makes me break out in particular) and flour to the largest extent you can.

Keep your blood glucose below 80 as much as possible. Spikes in glucose make me break out.