Frequently Asked Questions

Q. If I have acne, how often should I wash my face to keep it as clean as possible? Is it true that washing my skin frequently may cause it to secrete more oil?

A. How much oil your sebaceous glands produce is an inherited trait, governed by your hormones—it’s not affected by how much you wash. What frequent washing will do, though, is dry your skin out. This can make it more sensitive, more easily irritated, more red and tingly, and may cause superficial fissures that can be painful. Not really what you’re aiming for.

If you have acne, one thing that can make it worse is friction. This means people who try to combat acne by washing repeatedly—especially if they use a wash cloth or buff pad—end up just making it worse. When treating acne patients, I tell them to wash their face twice a day—three times at most. Soap, or a good cleanser like SkinUSA Gentle Cleanser works fine, and may be followed by a toner, or astringent solution, if there seems to be residual oil. Washing more than that is very irritating. I always suggest patients wash immediately before applying an acne medication such as Retin-A  or Renova (Airol in Europe) and those solutions have been shown to be necessary only twice a day.

Q. What causes brown spots on the skin, and what can be done about them?

A. There are a lot of reasons someone might have brown spots on the skin. One possibility is that the spots are left over from acne. As acne lesions heal, they can leave red or brownish spots that can take a long time to fade. Spots can also occur from direct damage from the sun—like freckles or lentigines, sometimes mistermed “age spots” or “liver spots.” (Lentigines have nothing to do with your liver—they’re caused by sun. They’re “age-related” only in the sense that you have to be old enough to have had sufficient sun exposure to get them.)

A third cause of spots is melasma, a mottled-looking brown discoloration on the cheeks and forehead. Melasma is more common in women, though it does occasionally affect men. It’s an inherited condition whose severity depends on the level of female hormones present, and on sun exposure. Women who tend to get melasma will get it more severely if they’re on birth control pills or when they’re pregnant. And, they’ll find it gets worse with sun exposure.

In each of these cases, bleaching or fading products can help, but only if you also address the cause of the spots. If the cause is acne, the most important thing is to treat the acne, thereby preventing new spots while the old ones fade. If you’re dealing with freckles caused by sun exposure, then, of course, the recommendation would be to limit sun exposure, and use sunscreen in addition to a bleaching cream.

Melasma patients should also limit sun exposure and (if possible) stop taking birth control pills.

Bleaching products are a combination of exfoliant (some mixture of alphahydroxy and/or polyhydroxy acids) to remove the surface layer of cells, and a lightening agent, hydroquinone (usually 2% in over-the-counter preparations; 4% by prescription). The idea is that the acid “peels back” the top layer of skin so the bleaching agent can get in deeper and work better. Some, such as SkinUSA Anti Aging Cream, also have a sunscreen built in to help prevent further sun damage, and to keep existing spots from becoming darker.

Q. Are bleaching agents applied just to the spots?

A. In most cases, you’ll get the best results by spreading the cream evenly over a larger area. If you just treat the spot, the edges tend to remain a little sharper than if you blend the cream out well beyond the edges of the spots. Bleaching creams will not affect your general skin color.

Facts and Fictions about Cosmetic Products