Azelaic acid: Again this is found in nature. It decreases inflammation & reduces pigment production via the tyrosinase enzyme pathway. Concentrations vary between 10 to 20%, with the gel formulation being the most stable. Super safe ingredient make this the number one choice for treating acne, PIH, & melasma in pregnancy.

What is the best way to treat melasma pigmentation?
This form of pigmentation is super common affecting up to ⅓ of women. The best cream for fading melasma hyperpigmentation is hydroquinone, however this ingredient should be limited to finite timeframes. HQ is rotated with azelaic acid, Kojic Acid, retinol & botanicals. Vascular modulators are second line therapy, followed by lasers.

For more information on how I manage this condition go to @101.skin IG or refer to the YouTube videos & many article write ups, including the melasma homepage.

What are the best creams for acne pigmentation?
There are several standout topicals for PIH secondary to acne. These include-

Azelaic Acid as this reduces pigmentation & treats acne.
Retinol & retinoic acid also reduces breakouts & addresses PIH
AHA’s & BHAs act as exfoliants, speeding up pigment extrusion & unclogging pores
Hydroquinone as a spot treatment
How do you treat pigmentation in pregnancy?
Melasma is the most common cause of pigmentation in pregnancy, often referred to as ‘The Mask of Pregnancy.’ Sun protection is paramount, creams such as AHAs, low strength BHAs, azelaic acid, liquorice root extract & green tea are all useful & safe in pregnancy.