Summary of "The ULTIMATE Routine for Dark Spots | Doctorly Hyperpigmentation and Melasma Guide"

Key Wellness Strategies, Self-Care Techniques, and Productivity Tips for Treating Dark Spots and Hyperpigmentation

Dark spots are flat areas of pigmentation that can appear due to various reasons. Common types include:

Causes of dark spots:

Molecular steps in hyperpigmentation:

Use a tinted sunscreen with at least SPF 30 that blocks both UV and visible light.
Especially important for darker skin tones.
Essential for the effectiveness of all other treatments.

Topical treatments should target all three molecular steps: pigment production, transfer, and deposition.

Ingredients targeting tyrosinase (pigment production):
- Prescription: Hydroquinone, tretinoin (retinoic acid)
- Over-the-counter (OTC): Retinol, arbutin, licorice root, kojic acid, vitamin C, niacinamide, glucosamine, mulberry, green tea, glutathione, allicin, rusinol, camarin
Ingredients targeting pigment transfer:
- Retinoids, soy, niacinamide, and others
Ingredients promoting pigment removal (increased skin turnover):
- Retinoids, exfoliants such as AHAs (mandelic acid, lactic acid), salicylic acid
Special ingredient:
- Tranexamic acid (inhibits plasma factors, reduces pigment production)

Oral treatments:
- Oral tranexamic acid (250 mg twice daily, under dermatologist supervision)
- Oral polypodium leucotomos (antioxidant)
In-office procedures:
- Microneedling
- Laser treatments (e.g., Fraxel, Clear and Brilliant, Halo)
- Chemical peels (must be carefully tailored to skin type to avoid worsening pigmentation)

Cleanse with a gentle, hydrating cleanser (avoid over-exfoliating products).
Apply antioxidant-rich treatments such as:
- Vitamin C serums (e.g., SkinCeuticals, L’Oreal Paris salicylic acid vitamin C)
- Niacinamide serums (e.g., First Aid Beauty with 5% niacinamide and licorice root)
Apply tinted or non-tinted sunscreen (tinted preferred for hyperpigmentation).
- Recommended products: Uriage Sensitive Skin Tinted Sunscreen, ALA MD UV Clear Tinted

Cleanse gently to remove makeup and sunscreen.
Apply treatment products:
- Retinoid (retinol, retinaldehyde, or prescription tretinoin)
- Dark spot targeted ingredients (e.g., arbutin, kojic acid, licorice root, tranexamic acid)
Exfoliate once a week (e.g., Paula’s Choice 6% mandelic acid, 2% lactic acid), but not on the same night as retinoids to avoid irritation.
Moisturize simply to avoid irritation and maintain the skin barrier:
- For oily skin: Simple SPF moisturizer
- For dry skin: Triple lipid peptide moisturizer

Hydroquinone and tretinoin are prescription-only and should be used under medical supervision.
Hydroquinone should not be used long-term due to the risk of paradoxical permanent pigmentation (exogenous ochronosis).
Alpha arbutin releases hydroquinone and should be used cautiously, especially when switching from hydroquinone.
Combining topical treatments with in-office procedures yields the best results; neither alone is sufficient for sustained improvement.
Avoid over-irritation to prevent worsening pigmentation.
Consistency and a layered approach addressing all pigmentation steps are key.

A new all-in-one dark spot treatment product is being launched, containing:

Encapsulated retinol
Mandelic acid (exfoliant)
Kojic acid, glutathione, licorice root, tranexamic acid, niacinamide, acetyl glucosamine, camarin, soy, turmeric

This formula is designed to target all three hyperpigmentation steps in one product.

Users can sign up for a waitlist to be among the first to try it.