Blog with Dr. Irwin

Asian skin

Side effects of hydroquinone 4% - is ochronosis really a concern?

Posted in Pigment problems, Asian skin, African american skin, 2012 on May 19, 2012 | Permalink

I am using hydroquinone 4% prescribed by a dermatologist. After reading about ochronosis on the internet, I'm quite scared. What are the symtoms of this? Does it appear immediately or is it gradual?

In the United States, the drugstore 'lightening' products are generally 1-2% hydroquinone. Over that percentage, hydroquinone is available only by prescription through a doctor. In the... more

Which laser would be best for acne scars if I'm Asian and had cystic acne?

Posted in Lasers, Asian skin, Acne Scars, Acne, 2012 on May 12, 2012 | Permalink

Dear Dr. Irwin, Being a fair Asian lady who had suffered from high grade cystic acne and completed a course of accutance, all I'm left with now is a face that is still somewhat pink and highly uneven. Certain parts of my face have sunk after accutane as previously, the lesions were protruding so much. I'd like to know if fraxel or mosaic would serve me better in leveling my skin and what I can do to lighten the pink patches left by the acne. Thank you.

Between these two, I would vote for the Fraxel (not the Fraxel Dual). It has much more data and experience behind it including several studies in Asian patients. The depth of... more

When is the best time to have the Fraxel Restore?

Posted in Pigment problems, Brown Spots, Asian skin, 2012 on Mar 28, 2012 | Permalink

What is the best time to have the first treatment for Fraxel 1550 Restore? I have an appointment to do my first treatment in late March but I am going on vacation to the Caribbeans in late May. I am Asian and am worried that going into the sun too much will lead to hyperpigmentation. Also, since the treatments are spaced out 4-8 weeks, my rest of my treatments will be in the summer-time.

These are all good questions to ask your doctor before your Fraxel laser treatment. The answers to these depend on a lot of factors. Questions your doctor may have could include the... more

With my Asian skin, when would be the best time to do a series of Fraxel Restore treatments?

Posted in Pigment problems, Fraxel laser, Asian skin, 2012 on Mar 20, 2012 | Permalink

I hear your concern and share it. You didn't mention where you live but since you mention summer, I'm thinking you live in a more four season climate. People who live in colder northern... more

Hormones and melasma - a complicated question?

Posted in Melasma, Brown Spots, Asian skin, 2012 on Mar 03, 2012 | Permalink

Dr. Irwin, My wife is an Asian in her late 40s and is suffering from melasma which appeared after extended sun exposure from a summer vacation last year. HQ, IPA (one cheek), and Fraxel Dual all made the melasma worse; Fraxel Dual, in particular, did the worst damage. She underwent a partial hysterectomy in late 2003 (ovaries intact). Our dermatologist recommended that her hormone levels be checked; blood tests are underway. The reproductive endocrinologist that we visited said that a visual exam of the vaginal wall indicated malfunctioning ovaries (hormones low), but the blood tests will give accurate measurements of how much. Everything that my wife has found regarding melasma is that hormone therapy makes the condition worse, but there must be a positive reason for my wife being referred to an endocrinologist. Do you think that hormone therapy might help or hurt her melasma (if the blood tests indicate low estrogen)? I can see other benefits for hormone therapy, but melasma has seriously adversely affected my wife's mental state; I would not want to encoursage her to seek hormone therapy if it might make her melasma even worse. I appreciate any insight you might provide. Thank you! KO

In general, estrogens in particular, more than progesterones or testosterone, make melasma worse. I have a couple of thoughts for you though.

At the recent Paris conference (IMCAS 2012)... more

What is causing these brown spots? Why can't I get rid of them?

Posted in Pigment problems, Menopause, Brown Spots, Asian skin, African american skin, 2012 on Feb 14, 2012 | Permalink

At age 55 I developed brown spots on my cheeks. I started the Obagi skin care regimen. About three years later, a large splotchy brown patch appeared on my cheek as well as patches on my jaws and brown spots on my forehead. I tried IPL and CO2 laser but they did not help. I went off the hydroquinone and went back on. Initially there is marked improvement but at about 7-8 weeks, the dark spot on the cheek starts to come back. I use a hat and sunscreen with 18 % zinc anytime I step out. I have never had HRT, never used oral contraceptives and have no family history of melasma. Despite following the doctor’s advice, I can’t seem to control the melasma. Should I use sunscreen even when I am indoors and not sitting in direct sunlight? Thank you for any advice that you can provide.

I recently returned from the IMCAS European conference on skin that was in Paris. There were excellent talks on pigmentation problems. There were several good points that were made. ... more

Is Cosmelan a good product for pigmentation problems?

Posted in Skin Care Products, Skin Care, Pigment problems, Asian skin, African american skin, 2012 on Feb 04, 2012 | Permalink

Dr, I am planing to get Cosmelan. I did my research and found out that Cosmelan has a new formula with Hydroquinone. It seems like the old formula was the best, and new formula has mixed reviews. Can you please advise on new Cosmelan. Thank you

I hope I'm wrong, but I'm very suspicious of this company - Mesoestetic. First, it's difficult to find out much about them. Their website constantly asks the user for information while... more

Melasma and Asian skin

Posted in Melasma, Asian skin, 2012 on Jan 08, 2012 | Permalink

Dr. Irwin, I'm Asian with skin type 4 and also suffering from melasma. What cream/moisturizer that you can recommend for my skin that can help with my melasma? My skin is also sensitive. I've been using the sunscreen you recommended and love it. Thanks!!

Melasma is one of the most difficult problems that Dermatologists face today because, at this point in time, as you all know, there is no true cure for it. There is just good... more

How risky is Fraxel laser for Asian skin?

Posted in Fraxel laser, Asian skin, 2011 on Dec 04, 2011 | Permalink

Dr. Irwin, How experienced are you with treating Asian skin with Fraxel? How were the results? I have read that there are some issues with post-inflammatory hyperpigmention, which I am most concerned about. Thank you

This is a good question. The best data on this comes from Dr. Henry Chan who is based in Hong Kong. One of his papers published in Lasers Surg Med 2007;39:381-5 titled "The prevalence... more

A question about darker skin under the arms and in the groin area.

Posted in Pigment problems, Body Treatments, Asian skin, 2011 on Nov 30, 2011 | Permalink

Hello Dr. Are the darkened skin in the pubic area and under arm also called melasma and do the medications for melasma such as renova, hydroquinon, and peeling work for those skins? I am an Asian woman and my skin in those areas are 3-4 degrees darker than the olive skin in the rest of my body and I feel embarrassed.Thank you for your help and advice.

First, generally this isn't referred to as melasma because it isn't caused by the interaction of female hormones and light exposure. Other causes can include genetic (other people in... more

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