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SANTA MONICA, Calif. - Melasma is notoriously difficult to eliminate, but adding cosmeceuticals to the treatment can improve chemical peel results, according to Dr. Cherie M. Ditre.
"I use a combination of retinols, combinations of antioxidants such as green tea, along with hydroquinones," Dr. Ditre said in an interview at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).
"Those three together are a powerhouse. And, occasionally, I'll add in alpha-hydroxy acids to actually help increase permeation through the skin."
The exact combinations depend on the procedure planned, said Dr. Ditre director of the University of Pennsylvania Health System's Skin Enhancement Center in Radnor.
If she is planning a chemical peel, for example, she has the patients "prepped first in the morning with an alpha-hydroxy acid cleanser starting at 10% and moving up. And then I also have them use hydroquinone at 4%. I can also titrate that in office to 6% or 8% depending on what they need. And then I go with an antioxidant such as green tea and a sunscreen."
She prefers sunscreens containing titanium dioxide and zinc oxide, and recommends Anthelios, which contains Mexoryl, and is a Food and Drug Administration-approved sun filter.
For the evening, Dr. Ditre instructs her chemical peel patients to use an alpha-hydroxy acid cleanser with a retinol that she titrates based on skin type and condition. She mixes that with an antioxidant such as green tea.
"I do that for a period of about 2 weeks prior to the chemical peel," she said. "The chemical peel that I'm presently using is a combination of a 1% retinol with 14% hydroquinone, and we leave it on as a masque for about 5-8 hours to wash off at home. And then, for the following 2 weeks, they use a regimen of a retinol and hydroquinone along with their sunscreen and a calming lotion," after which patients will return for follow-up.
Dr. Ditre said she has never seen an adverse reaction to green tea, which she described as "very gentle." Retinols are another story, however.
"Some of the retinols can approximate retinoic acid, so you have to be careful in very sensitive skin patients," she said. "I think that starting with the 2X [concentration] is better for sensitive skin patients. And that's why you do it as a prep prior to actually doing procedures, to make sure it's agreeable with them prior to doing a more invasive procedure."
Dr. Ditre reported having no disclosures. SDEF and this news organization are owned by Elsevier.
SANTA MONICA, Calif. - Melasma is notoriously difficult to eliminate, but adding cosmeceuticals to the treatment can improve chemical peel results, according to Dr. Cherie M. Ditre.
"I use a combination of retinols, combinations of antioxidants such as green tea, along with hydroquinones," Dr. Ditre said in an interview at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).
"Those three together are a powerhouse. And, occasionally, I'll add in alpha-hydroxy acids to actually help increase permeation through the skin."
The exact combinations depend on the procedure planned, said Dr. Ditre director of the University of Pennsylvania Health System's Skin Enhancement Center in Radnor.
If she is planning a chemical peel, for example, she has the patients "prepped first in the morning with an alpha-hydroxy acid cleanser starting at 10% and moving up. And then I also have them use hydroquinone at 4%. I can also titrate that in office to 6% or 8% depending on what they need. And then I go with an antioxidant such as green tea and a sunscreen."
She prefers sunscreens containing titanium dioxide and zinc oxide, and recommends Anthelios, which contains Mexoryl, and is a Food and Drug Administration-approved sun filter.
For the evening, Dr. Ditre instructs her chemical peel patients to use an alpha-hydroxy acid cleanser with a retinol that she titrates based on skin type and condition. She mixes that with an antioxidant such as green tea.
"I do that for a period of about 2 weeks prior to the chemical peel," she said. "The chemical peel that I'm presently using is a combination of a 1% retinol with 14% hydroquinone, and we leave it on as a masque for about 5-8 hours to wash off at home. And then, for the following 2 weeks, they use a regimen of a retinol and hydroquinone along with their sunscreen and a calming lotion," after which patients will return for follow-up.
Dr. Ditre said she has never seen an adverse reaction to green tea, which she described as "very gentle." Retinols are another story, however.
"Some of the retinols can approximate retinoic acid, so you have to be careful in very sensitive skin patients," she said. "I think that starting with the 2X [concentration] is better for sensitive skin patients. And that's why you do it as a prep prior to actually doing procedures, to make sure it's agreeable with them prior to doing a more invasive procedure."
Dr. Ditre reported having no disclosures. SDEF and this news organization are owned by Elsevier.
SANTA MONICA, Calif. - Melasma is notoriously difficult to eliminate, but adding cosmeceuticals to the treatment can improve chemical peel results, according to Dr. Cherie M. Ditre.
"I use a combination of retinols, combinations of antioxidants such as green tea, along with hydroquinones," Dr. Ditre said in an interview at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).
"Those three together are a powerhouse. And, occasionally, I'll add in alpha-hydroxy acids to actually help increase permeation through the skin."
The exact combinations depend on the procedure planned, said Dr. Ditre director of the University of Pennsylvania Health System's Skin Enhancement Center in Radnor.
If she is planning a chemical peel, for example, she has the patients "prepped first in the morning with an alpha-hydroxy acid cleanser starting at 10% and moving up. And then I also have them use hydroquinone at 4%. I can also titrate that in office to 6% or 8% depending on what they need. And then I go with an antioxidant such as green tea and a sunscreen."
She prefers sunscreens containing titanium dioxide and zinc oxide, and recommends Anthelios, which contains Mexoryl, and is a Food and Drug Administration-approved sun filter.
For the evening, Dr. Ditre instructs her chemical peel patients to use an alpha-hydroxy acid cleanser with a retinol that she titrates based on skin type and condition. She mixes that with an antioxidant such as green tea.
"I do that for a period of about 2 weeks prior to the chemical peel," she said. "The chemical peel that I'm presently using is a combination of a 1% retinol with 14% hydroquinone, and we leave it on as a masque for about 5-8 hours to wash off at home. And then, for the following 2 weeks, they use a regimen of a retinol and hydroquinone along with their sunscreen and a calming lotion," after which patients will return for follow-up.
Dr. Ditre said she has never seen an adverse reaction to green tea, which she described as "very gentle." Retinols are another story, however.
"Some of the retinols can approximate retinoic acid, so you have to be careful in very sensitive skin patients," she said. "I think that starting with the 2X [concentration] is better for sensitive skin patients. And that's why you do it as a prep prior to actually doing procedures, to make sure it's agreeable with them prior to doing a more invasive procedure."
Dr. Ditre reported having no disclosures. SDEF and this news organization are owned by Elsevier.