Kinder, gentler remedies aid hyperpigmentation

Aging, disease, sun exposure, laser treatment and heredity can leave their mark on the skin with blotches of pigmentation. As a remedy, dermatologists often recommend bleaching agents, laser treatment and even surgery. But what about less- invasive remedies?

Zoe Draelos, M.D,. says that, in many cases (for example, melasma, age spots and freckles), the pigmentation is UVA- driven; therefore, using a UVA sunscreen is the first step in reversal.

To date, the U.S. Food and Drug Administration has approved only three substances that block full-spectrum UVA radiation: microfine zinc oxide, micronized titanium dioxide and avobenzone. Micronized zinc oxide reflects light and absorbs primary and secondary oxygen radicals, while the small, evenly sized particles minimize skin whitening. Micronized titanium dioxide, on the other hand, has variable particle sizes. This offers excellent photoprotection but can whiten skin.

A clinical associate professor of dermatology at Wake Forest Univers-ity School of Medicine in Winston-Salem, N.C., and a Dermatology Times editorial adviser, Dr. Draelos tends to stage patients from sunscreens to hydroquinone alone or in combination with retinoids and glycolic acid. But for some patients, she admits make-up can be a viable alternative.

Says Dr. Draelos, "You can use an opaque stage-type make-up like Dermablend, but for the average person, it's hard to apply and more make-up than they want to use."

On further reflection, she adds, "Some of the cream powder make-ups might work better. You can add titanium oxide and cover with powder to set the underlying foundation."

The Hollywood perspective Make-up artist Maurice Stein agrees that Dermablend is "way too heavy," producing a "theatrical" look. But he says that's because it's formulated from oil vaseline, wax and color pigment.

After 25 years in the entertainment industry where he did make-up for actors in "Planet of the Apes," "Golden Girls" and many other shows, Mr. Stein decided to become an entrepreneur. Today, his company, Cinema Secrets, sells an oil-free foundation for people of all ethnicities who have discoloration problems, ranging from age spots and freckles to tattoos, bruises and vitiligo. He also lectures on this topic to cosmologists, aestheticians and medical professionals.

Notes Mr. Stein, "Dermatologists tend to do heavy peels, bleaching or laser treatment. Quite often this helps, but there can be a long recovery period. Applying a small amount of foundation is the easiest solution. It's guaranteed - without any side effects."

His average client is a 40- to 60-year-old woman who wants to look as natural as possible without heavy dermatological treatments. To hide pigmentation, he uses the Cinema Secrets foundation, which he asserts has two to three times the coverage of the average liquid foundation.

Says Mr. Stein, "First you find a color that is compatible, and then you place it on a sponge and apply in a patting or stippling motion. You set it with a loose, mineral-based translucent powder. If there is still a dramatic difference between the pigment and skin tone, apply another thin layer over the powder."

He argues that there is no need to add titanium oxide to cream powders because there are foundations on the market, such as his own and Krylon, already formulated with it. He advises customers to use a non-oily sunscreen or block, such as Total Block by Fallene, prior to applying make-up. Total Block is available in two tones: clear and colored. The latter doubles as a combin-ation sunscreen and foundation and comes with tubes of pigment so that users can customize the tone.