Dr. Obagi’s Skincare Routine for Dyschromia

Ephelides, lentigines, PIH, melasma? This is Dr. Suzan Obagi’s go-to skincare routine for patients with dyschromia.

This is part 2 in a 2-part series

Part 1: How to Safely Treat Patients with Darker Skin Types

No matter which condition the patient has, it is imperative that the skin is prepped properly before any procedure and that the skincare is resumed immediately once the skin has healed from any procedure. My go-to skincare routine for any patient with dyschromia, regardless of skin type is:

Morning

  1. Cleanser
  2. Toner
  3. 1 g 4% Hydroquinone
  4. ½ g to 1 g AHA or PHA
  5. Mineral-based sunscreen

Evening

  1. Cleanser
  2. Toner
  3. ½ g to 1 g 4% Hydroquinone
  4. Retinoid
    1. 1 g 0.05%-0.1% Tretinoin
    2. 1 g 0.1% Retinaldehyde

An easy way to make sure patients are measuring the products they apply to their skin properly is by instructing them on measuring 1 g, as one finger-tip unit.

The key with the skincare routine is to target the keratinocytes (normalize atypia, increase turnover, make the stratum corneum more hydrated and compact) and the melanocytes (decrease pigment production, normalize melanin distribution to keratinocytes, normalize skin distribution of melanocytes). Thus, each product suggested has a key function to play in improving the condition of the skin.

I hope that this article helps to demystify the pigmentation issues our patients present with and helps physicians feel more comfortable treating patients with darker skin. Treating pigmentation issues in patients with darker skin can be very rewarding for both the physician and the patient. Tread carefully and build your confidence by seeing these patients closely in follow up until you are able to predict the outcomes of your treatments and the patient’s skin response to them.

Dr. Suzan Obagi is recognized as one of the world's most respected cosmetic surgeons and dermatologists. Dr. Obagi is an associate professor of dermatology and associate professor of plastic surgery at the University of Pittsburgh Medical Center and serves as the director of the state-of-the-art UPMC Cosmetic Surgery & Skin Health Centers.