Managing Melasma

‘e worst DIY hyperpigmentation mistakes for skin of colour and how to avoid them.

A deep dive into the worst DIY hyperpigmentation remedies for skin of colour and how to avoid them.

Abeautiful young lady walked into my clinic once with a black burn mark across her face. She was distressed and I couldn’t think what had caused the mark. I wish I could say it was the last time I ever saw something similar. This young lady had been watching YouTube videos on how to clear blemishes and was told to use apple cider vinegar. This is disastrous because the pH of skin is 4.5-6.5 but the pH of apple cider vinegar is 2-3 and skin is not equipped to tolerate such a low pH. As a result, apple cider vinegar burns the skin and our large, sensitive melanocytes kick into gear, spitting out extra melanin in anger. For those with skin of colour – five in seven people – our melanoctyes do not tolerate any form of inflammation.

Hearing this was the exact moment I decided to create my YouTube channel (Dr. Vanita Rattan) to explain what we can and can’t do to our skin, based on first-hand clinical data.

I often hear the phrase: ‘If it’s good enough to eat, it is good enough to put on my skin.’

The stomach contains gastric acid, it is designed for a low pH of 1-3, which is necessary when you are breaking down protein and digesting your food. Your skin, however, can’t tolerate this low pH, and any irritation from an extremely acidic substance damages the skin barrier. This leads to more transepidermal water loss (TEWL), and as a result your blood vessels expand and inflammatory mediators flood the a ected area, which leads to dryness, redness, darkening or peeling of the skin. This inflammation can then trigger your melanocytes, which can cause postinflammatory hyperpigmentation (PIH).

I have also seen upper lip burns from people using ginger and potato on their skin, as well as from trichloroacetic (TCA) peels purchased online. These are just a few examples, and there are many more.

Lemon juice is the number-one culprit. A client was following a trusted lifestyle influencer who demonstrated how she used lemon juice to brighten her skin. My client proceeded to do the same, but this damaged her skin barrier, which led to redness, then hyperpigmentation. Thankfully we treated the skin in time so there was no long-lasting damage. However, this is a common mistake, and without intervention it can leave you with a lifetime of hyperpigmentation.

People think lemon juice is great as its vitamin C and citric acid brightens and exfoliates dead skin, but it does more harm than good.

In addition, inflammation can occur when citrus sits on the skin during the day if you are out in the sun with UV rays on your face, which may present as redness or burgundy colour, swelling and blistering. This is why you should always wash your lips after eating citric fruit, especially in the sun.

Note: Citric acid used to bu er a cream is not at a high enough percentage to cause a reaction.

Scrubbing with whole grains is another common problem. I did a reaction video to some celebrities on YouTube who show their ‘homemade’ skincare routines, and this was one of the worst ingredients used.

Whole grains are uneven, have sharp edges and can lead to micro tears of the skin, because they are an uncontrolled ingredient. This damages the skin barrier, leading to redness or burgundy colour, irritation, breakouts and sensitivity.

Garlic – I have seen a patient in my clinic who thought using garlic on the upper lip would improve melasma. Unfortunately, garlic is another natural ingredient that can lead to chemical burns, leading to more hyperpigmentation.

The main chemical ingredient in garlic that causes these burns is diallyl disulfide. This can cause contact dermatitis and rashes.

Apple cider vinegar for acne – the process of fermenting apple cider to make vinegar gives the finished product a low pH, and it contains both malic acid and citric acid at high concentrations. So unfortunately, apple cider vinegar is very acidic and can cause burns when applied directly to skin.

My final thoughts on DIY hyperpigmentation treatments?

The risk/reward ratio doesn’t work in your favour. You need to use tyrosinase inhibitors at the correct percentages, formulated in the right way, to e ectively reduce the rate of melanin production.

The best you can achieve with DIY treatments is to strip away the top layer of skin, which any scrub can do. I am not a fan of scrubs to exfoliate skin of colour, as you aren’t just removing the top layer of dead skin cells but potentially causing other problems such as uneven removal of dead skin cells.

Melasma presents as skin discolouration of the face. Those dark-brown patches often start as innocent freckles in your late twenties and thirties and although people think these freckles are initially ‘cute’, they are an early warning sign that you are inadequately protecting your skin from UV damage. Those freckles join up and form patches, they then start to form on other parts of the face.

Common treatments for melasma – laser, high-strength TCA/glycolic acid peels and hydroquinone – have side-e ects that lead to more hyperpigmentation for skin of colour.

These treatments are suited to Caucasian skin, because even if they do cause burns (Fitzpatrick Scale 1-2) they don’t cause more hyperpigmentation.

Best treatment for melasma for skin of colour?

There are professional-grade treatments you can try for your melasma, but if you prefer to give some other options a try first, there are several actives you can use to treat your skin instead (see overleaf).

You will see that tyrosinase inhibitors feature a lot among these actives. However, you are unlikely to see much of a reduction with just one or two. I prefer using a cocktail of gentle tyrosinase inhibitors to treat hyperpigmentation for skin of colour; they do not burn or lead to PIH for skin of colour when formulated correctly.

“Approximately five in seven people in the world have skin of colour and despite this figure, fivesevenths of skincare products do not cater to skin of colour. Common nd treatments for melasma – laser, high-strength TCA/glycolic acid peels and hydroquinone – have side-effects that lead to more hyperpigmentation for skin of colour.”