A derm’s guide: the 411 about severe acne

Severe acne: Our favourite dermatologist Dr. Lev Naidoo talks about what it is, how to recognise it, and how to treat it.

Following our previous topic, The do’s and don’ts of acne, I now focus on severe acne: which factors mean your acne has become severe? When should you seek medical help? Is acne medication safe? How to look after your skin…

When should you see a doctor or dermatologist for your acne?

If you’ve tried over-the-counter topical products like benzoyl peroxide, addressed your diet, make-up application and skin care products as best you can and your acne persists, or if you would prefer a guided approach to your skin treatment plan from the outset, a visit to a medical practitioner would help a) to get control of your breakout, and b) to limit the extent of scarring.


signs of nodulocystic acne


How does a doctor tell when acne has become severe?

When a patient comes to me for a consultation, I look at both clinical and patient factors.

Clinical factors include the type of acne: has it become nodular (hard lumps under the skin) or cystic (inflamed, tender, red)? Does the acne only involve the face or also the chest and back?

I assess scarring factors – does the acne heal with a tendency to increased pigmentation or surface irregularities, such as underscored dips in the skin or keloidal scars?

Patient factors I take into consideration include how the patient has responded to previous treatment measures and whether the acne is affecting them either personally or professionally.

All these factors direct me to recommend the introduction of a systemic or oral treatment plan.


‘Care for acne-prone skin is often a journey based on how your acne changes, and factors like change in stress levels or season may aggravate it… Go easy on yourself!’


What can you expect from a visit to your healthcare practitioner?

The doctor will take a complete history about your acne, followed by a clinical examination. This will direct them toward a skin-care plan they consider suitable for you.

Acne that presents as blackheads and whiteheads may be treated with a combination of topical agents, such as retinoid (vitamin A) creams, antibiotics or benzoyl peroxide.

Acne that has more raised inflamed or pustular lesions will usually require an oral treatment plan. This could include an oral antibiotic for a period of four to six months. Please remember, acne is an inflammatory and not an infective process. Antibiotics are used for their anti-inflammatory effect.

Most doctors will usually script an oral antibiotic along with a topical cream – for example, a topical retinoid (vitamin A cream such as Differin) – for a synergistic effect.

For women, the combined oral contraceptive pill is an alternative option to an antibiotic. This regulates hormone production and is particularly beneficial in patients with underlying medical conditions like Polycystic Ovarian Syndrome, which may contribute to acne forming.



What can you use if an introductory management plan yields disappointing results?

Are you still experiencing breakouts despite using the above measures? Are you prone to scarring or feel your acne is affecting your personally, emotionally, or professionally?

You may then consider the option of a systemic retinoid, if your dermatologist feels this is appropriate for you. Systemic retinoids are a form of vitamin A, and options available in the country include Roaccutance, Acnetane and Orotrane.

Is Roaccutance, Acnetane and Orotane safe?

Systemic retinoids remain the gold standard for severe acne as well as acne that tends to heal with scarring.

They are an excellent treatment choice, provided dosage is tailored to the patient, you are monitored clinically and biochemically with regular blood tests, as well as advised on the affect of the medication and supportive care needed whilst on the treatment.


Medical treatment for severe acne


Are there contraindications to taking Roaccutane?

There are some situations where Roaccutane may not be taken by a patient. Females should not fall pregnant whilst on treatment, as it is associated with birth defects in the baby. Your doctor will give you more in-depth details about cautions, adverse effects and contraindications before you start treatment.

Are there alternatives to systemic retinoids that may effectively control severe acne?

Spironolactone is a testosterone-blocking medication traditionally used to control blood pressure. It may be used at a low dosage by dermatologists to treat women with severe acne. Blood tests would be required whilst on this medication, and pregnancy should be avoided whilst on it, as it may lead to feminisation of a male baby.

What supportive skin care should you use while you are on systemic retinoid treatment?

As retinoids regulate sebum (oil) production, your skin will become drier while you are on the medication. A switch to a cleanser that is less stripping or irritating on the skin is advised. I like Bioderma’s Sensibio Gel Moussant for its gentle cleansing properties.

Avoid physical scrubs and toners as they may irritate your skin and decrease tolerance of the acne medication.

LBC also recommends gentle cleansing for sensitised skin:

Noreva Actipur Dermo-Cleansing FoamNoreva Dermo-Cleansing Soap-free Gel and Bioderma Sensibio H20


Bioderma and Noreva products for severe acne


Moisture is a must

Many acne sufferers don’t like to use moisturiser, because they are afraid of the skin feeling oily. Routine use of a moisturiser that is hydrating, but not oily, is important while on any form of acne care, as all forms of treatment have the tendency to dry or irritate the skin. Adding a moisturiser to your skincare routine will increase your tolerance of the medication and make your skin feel much more comfortable.

Moisturisers I recommend for my patients on systemic retinoids include Bioderma’s Sébium Hydra and Noreva’s Exfoliac Reconstructive Cream. Both are excellent products that maintain the integrity of the skin barrier against dehydration and decrease redness and sensitivity.

Lips will also become dry and flaky. This is a sign that shows you are responding to the treatment! Avoid lip-licking, which further dries out your lips, and apply a lip balm frequently. A product I like is Bioderma’s Atoderm Baume Lèvres Restorative Lip Balm. It contains a combination of shea butter, beeswax and vitamin E that restore and maintain a healthy, supple lip texture.

LBC also recommends 

Noreva Xerodiane AP+ Relipidant Balm for skin moisturisation.

Sun protection is not negotiable

Your skin will become more sun-sensitive whilst on a systemic retinoid. It is essential you adopt sun protective behaviours: use a good quality sunscreen, avoid sun exposure during peak intensity hours, seek shade when outdoors, use protective clothing as well as sun hats.

I recommend sunscreens such as Bioderma’s Photoderm Nude Touch and Bioderma’s Photoderm MAX Aquafluide. Both have a light texture with an elegant velvet matte finish.

And lastly…

If you have severe acne – especially if you have a strong family history of acne, or if you’ve been on repeated courses of treatment for control – you may benefit from a maintenance topical cream therapy to preserve the effect of the short-term oral course of treatment. Discuss this with your medical practitioner.

Care for acne-prone skin is often a journey based on how the presentation of your acne changes, and factors like alterations in stress levels or seasonal variation may aggravate the acne. Be flexible to medical advice that is changed accordingly.

As with most skin conditions, acne control works on a timeline of months – not weeks or days. Go easy on yourself!

Here’s wishing you happy skin days,

Dr. Lev
Dr Levashni Naidoo






A Derm’s Guide: The Do’s and Don’ts for Acne

Our favourite dermatologist Dr. Levashni Naidoo gives us her 9 steps to a clear skin

I’ve been an acne sufferer since adolescence and, before I became a dermatologist, managing my skin was frustrating. I wished I could speak to someone who had successfully navigated the break-out chapter of their life.

My experience as an acne-prone teenager was fairly typical:

My skin felt oily and I thought it would help if I cleansed more frequently and vigorously. I was wary of moisturiser, as it made the oiliness of my T-zone worse. I had a phobia of sunscreen – I could almost feel the onset of a new acne flare-up when I was forced to apply the tacky substance to my face.

In desperation, I tried a number of natural home remedies one after the other and then together. As I stood despondently in front of my bathroom mirror watching my spots change from a strawberry tone to fire-engine red, I wished I could speak to someone who could give me good advice.

Now, as an adult woman who is still acne-prone, I wish I could tell my younger self to breathe, stop picking, step away from the mirror and follow these simple steps…

Step 1: Always be gentle

Cleanse gently twice daily. Aggressive scrubbing may seem like the right thing to do and may feel comforting psychologically, but an aggressive cleansing routine stimulates your sebum (oil-producing) glands to produce more oil.

Le Beauty Club recommends:
For teen acne: Bioderma Sébium Foaming Gel, Noreva Exfoliac Cleansing Gel
For adult acne and sensitive skin types: Noreva Actipur Dermo-Cleansing Foam, Bioderma Sébium H2O

Acne and oily skin cleansers


Step 2: Treat your acne

Acne is a complex inflammatory process. It is not only about overproduction of sebum (skin oil); the composition of that sebum is also the cause of blackheads and whiteheads – the building blocks for pimples and acne nodules. You need to use a skin treatment with ingredients that regulate the amount of sebum produced as well as the quality of the sebum. This helps prevent pores becoming blocked – the cause of the vicious cycle of blackheads, whiteheads and pimples.

I recommend treatment like Bioderma’s Sébium Global. Ingredients like zinc gluconate regulate sebum production, and patented SeboRestore Complex improves the quality of sebum, preventing it becoming thicker and clogging up your pores. Salicylic acid and alpha-hydroxy acids chemically exfoliate the skin gently, improving skin texture and clarity.

Le Beauty Club also recommends:
For moderate to moderate acne: Noreva Exfoliac Acnomega 100
For sensitive skin prone to acne: Noreva Actipur 3in1 Corrective Anti-Imperfection Care, Bioderma Sébium Sensitive Soothing Anti-Blemish Care

Acne treatment & moisturiser


Step 3: Yes, you can (and must) moisturise acne-prone skin

I’ve found in my practice that people with acne commonly fear moisturiser. My aim is to get my patients to change their mindset. Instead of trying to dry out their skin by every means possible, they need to become comfortable with using a moisturiser.

Oily skin can become very dehydrated, especially if you strip away its protective barrier film, which prevents water loss. This can cause the skin to produce more oil to stop this water loss. So the answer is to use an oil-free moisturiser. This keeps skin comfortable and helps with skin hydration.

Le Beauty Club recommends:
Bioderma Sébium Mat Control


‘Remember acne is an inflammatory process. The skin needs to be rehabilitated… time is necessary for improvement.

Realistically, it will take up to two to three months to see a marked improvement’


Step 4: Sun Protection is essential!

Sun protection is an important part of your acne care. You may notice that when your acne heals, there is darker pigmentation on the area. And this post-inflammatory hyperpigmentation may last a great deal longer than the acne itself.

Protection from ultraviolet, infrared and visible light helps prevent this pigmentation becoming worse. And on affected skin, it will help with a speedier return to your original complexion.
It’s important to remember that most treatment options for acne increase the skin’s sensitivity to sunlight – another reason sunscreen is a vital component of any complete skin care regime if you are serious about improving the appearance of your acne.

Newer sunscreens are formulated with microparticle technology so they do not have a thick and greasy texture, they are absorbed rapidly and leave a nice matte finish.
Sunscreens I love from the Bioderma range for acne-prone skin include Bioderma’s Photoderm Aquafluide with a dry-touch finish, which has beautiful mattifying properties, and Bioderma’s Photoderm Nude Touch – a mineral-based sunscreen for those sensitive to chemical filters. Photoderm Nude Touch has an evolutionary liquid-to-powder finish, leaving your skin with an elegant finish.

Le Beauty Club also recommends:
Noreva Exfoliac Matifying Suncare Fluid SPF 50+

Sunscreens with ingredients that help treat dark marks: Institut Esthederm Photo Reverse, Bioderma Photoderm M SPF 50+, Bioderma Photoderm Spot SPF 50+, Noreva Iklen Anti Brown Spot SPF 50+

Acne sun protection


Step 5: Don’t pick at your pimples

Despite what you may see on social media or television, there isn’t a right way to pop a pimple. Popping, pinching or squeezing carries the risk of driving the inflammatory process deeper into your skin and leaving scarring of a permanent nature. Try to resist the temptation. Use a treatment instead.

Step 6: Avoid heavy make-up

In the myriad-filtered world we live in, asking someone with acne to leave home without a long-lasting foundation seems like stripping them of a layer that shelters them from enquiring glances.

The truth is, as comforting as a heavier make-up cover may feel, occlusion (pore-blocking) of any sort may make your acne worse. Rather use a concealer on areas that bother you more, and use a lighter, breathable foundation over the rest of your face.

Le Beauty Club tip: Using clean hands or brush, pat on the concealer and build up the coverage where you want it.

Le Beauty Club recommends:
Noreva Exfoliac Tinted Anti-Imperfections CareLight and Golden – a tinted treatment for oily and acne-prone skin

Step 7: Watch Your Diet

Numerous studies have been conducted on diet and acne, and while there isn’t an association with any particular food group, the association between a high gylcaemic index diet and acne has been confirmed. So, as with most things in life, an exercise in moderation does show benefits.


Step 8: There Is No Quick Fix!

In moments of desperation, we are more prone to trying or believing any remedy that is shared with us or that we read about, no matter how weird (applying toothpaste to your acne is never a good idea).

Remember, acne is an inflammatory process. The skin needs to be rehabilitated medically – either topically (with a treatment cream) and or orally, depending on its severity.
And, as the term rehabilitation implies, time is necessary for improvement. Realistically, it will take up to two to three months to see a marked improvement in any safe, effective acne programme.

Step 9: There is always hope – even for the most challenging acne cases

I frequently see challenging acne cases. Whether you’re a teenager anxious about the departure from smooth skin or an adult frustrated by breakouts you have come to feel is your lot, don’t despair!
There is always something that may be altered in terms of the actual ingredient or delivery of ingredients that may help you on your path to smoother skin!


Here’s wishing you happy skin days,

Dr. Lev
Dr Levashni Naidoo
If you struggle with severe acne issues, keep a look out for our April blog post: A derm’s advice on severe acne.

Time for romance… Valentine beauty gets real

Love is in the air, in your eyes… and on your skin. Make a special effort to look and feel fantastic for your love object – that includes yourself…

In an ideal world, we’d show our partners care and consideration every day, but juggling life’s demands can be so hectic that couple time is often not as frequent as it should be. Use Valentine’s Day as a gentle reminder to stop and smell the delicious bouquet of roses and why not make space for romance?

Radiant face

A smooth skin is a radiant skin. Slough off old skin cells with Bioderma Sébium Pore Refiner or Noreva Exfoliac Facial Scrub.

Next, give it a drink of moisture and softness:  Try Noreva Aquareva Light or Rich or Bioderma Hydrabio Perfecteur SPF 30.

radiant moisturised skin

Soft, caressable skin for both of you

The skin on your body, hands and feet should feel like velvet. You don’t want to feel any roughness or snagging.

Gentle cleansing

Couple time gets even more alluring when you have smooth body skin and smooth, soft feet. In the shower, get soft and moisturised skin with Bioderma Atoderm Shower Gel, then buff it with a gentle body scrub or loofah to leave the skin clear of blemishes and rosy with health.

Close shave

Few things are more off-putting than stubble prickling your partner. Make sure you’re as smooth as baby.

For her For lasting smoothness, have your legs waxed, or DIY by shaving or using a depilatory cream. The latter lasts longer, but first do a skin-sensitivity patch test if you‘ve never done it before.

For him Please shave your face. Five o’clock shadow will give your partner’s delicate skin carpet burn. Afterwards, apply a post-shaving balm to soften your skin and beard hairs. Try Bioderma Sensibio Forte.

Moisture must

For both of you Don’t dry your skin completely when you step out of the bath or shower. If you leave it slightly damp when you apply lashings of body lotion, it will be doubly moisturised. Use a neutral body lotion (we like Bioderma Atoderm Milk), then spray your chosen fragrance in the air and walk through the mist for an overall fragrance kiss.


Show-off tips

Get pretty fingertips and tootsies with a rich, jewel shade are eye catching. Pair your signature shade with a stunning outfit or your favourite slinky negligee and you’re sure to have a great night.

Be nice to be near

The feel of your skin and the scent of your favourite fragrance can be addictive to the object of your desire, as sense of smell is directly connected to our limbic brains, the seat of our emotions so, when they smell your trademark scent, it will affect them instantly.

Application rules: Certain areas on your body are hot spots for scent. The heat they generate makes fragrance come alive and linger. Apply it behind your ears, between your breasts, on elbow creases, behind knees and on inner wrists.

Hint: if you decide to try something new, make sure you know it’s something he or she will love. On your way out the door, spritz on a fragrance to finish off the ultimate love package.

Who wants to kiss and make up?

We fall in love by gazing into each other’s faces and our brains register our mood continually with what they reveal. So you want to send the right message…

Valentine beauty foundation and blush

First contact

If you’re stepping out with your beau or besties, a glowing skin is needed for any and all occasions. Reflect your radiance from the inside out with Bourjois City Radiance Foundation. The formula contains radiance-boosting pigments to even out skin tone – all for a more natural, fresh, radiant complexion. The SPF30 allows you to take a romantic stroll on the beach, carefree! If, on the other hand, you have an oilier complexion, you’ll love Bourjois 123 Perfect CC Cream, which evens out skin tone as well.

Next, add a tinge of blush to soften the mood, the Bourjois Little Round Pot makes it easy to swipe on and slip it into your bag for a sneaky touch-up.

Come-hither eyes

The eyes are the most important tool of seduction – after all, how can you fall in love without eye contact? Make sure your eyes look beautifully relaxed by erasing all signs of tiredness with an instant pep-up eye cream. Try Noreva Noveane 3D Rollon Anti-ageing Eye and Lip Cream.

Make your eyes speak volumes with either of these two beauties: Bourjois’s lashious Volume Glamour Push Up Mascara or Bourjois Volume Reveal Mascara.  

A soft, smoky look is super easy with Bourjois Smoky Eyes Trio Eyeshadow.

Kiss-me lips

For both of you: Lips should be soft and smooth for kissing, so eliminate dry, rough skin and give them a rosy glow by brushing them gently with a wet toothbrush.

Apply a nourishing lip balm Bioderma Atoderm Restorative Lip Balm and let it soak in for a while.

Breath should be sweet, so brush and floss well and keep some Xylitol mints handy if you’re having a spicy meal.

Finally, pucker up in high definition with Bourjois’ iconic Rouge Edition Velvet Lipstick, which has serious staying power and looks ultra-plush.

At the end of the night, don’t forget to take it all off with micellar water – Bioderma H2O or Noreva Universal Cleansing Lotion.

Happy Valentine!

Present time! Your guide to gift and holiday shopping

The season of (gift) giving is here. Are you ready? We’ve  put together our top festive ideas for every person on your list. Hold onto your make-up brushes, because these will knock your reindeer socks off!

Beauty Bestie

Your beauty-obsessed bestie is always up-to-date with the latest products… that’s why Revlon’s PhotoReady collection is a winner! The Insta-Filter Foundation, Color Correcting Pens, Prep, Set, Refresh Mist and Contouring & Highlighting Palettes cover all the bases. And who could resist the beautiful eye-shadow compacts from Maybelline?

Throw in a brilliantly-priced Bioderma Hydrabio bundle with H2O Micelle Solution 500ml and she will love you forever.

Merry Men

Make sure the men in your life get a pamper session. Ease them into their new & improved self-care routine with something familiar: Wella Shockwaves Clean Cut Wax will have their festive fros looking sleek and easy! Match that with a summertime skin care regime that consists of Bioderma Atoderm Gentle Shower Gel and Moisturising Milk. And spoil him (and yourself ;)) with one of the delicious David Beckham fragrances.

Bouncing Baby

Shopping for a tot or two? Both baby and mom will thank you for making bath time a treat with Mustela’s limited-edition HydraBébé Body Lotion, Gentle Cleansing Gel and Gentle Shampoo.

And who wouldn’t love the beautiful Mustela Musti fragrance? The baby friendly Musti Eau de Soin fragrance, enhances your baby’s well-being and stimulates their senses with subtle citrusy and floral notes. 100% free of alcohol, parabens, pthalates, phenoxyethanol. Hypoallergenic.

On a budget?

We don’t always have the spare cash to splurge on treating ourselves or others. Good to know, then, that you can still give the best presents – available at great discounts. Check out our Hot DealsUltimate Skincare Bundles and selected skincare specials

Travel companions

Off to the beach?

You need the best protection against the summer sun’s harmful rays.

For babies and small children: We recommend Mustela Very High Protection Sun Lotion (SPF 50+), specially formulated for baby skin. It’s designed to not rub off with beach sand.

For the whole family: Bioderma Photoderm MAX SPF 50+ Spray 200ml. He will like it too, as it is easy to use.


Colder Christmas 

Off to a cooler destination? Stock up on double-duty beauties and chill protectors. Bioderma Sensibio H2O – your 2-in-1 cleanser/make-up remover – is a great place to start. Add Noreva Xerodiane Plus Crème Lavante Cleansing Cream, it’s the great all-rounder face and body cleanser for infants, children and adults, and it’s perfect for extremely fragile, damaged skin in (all-rounder!).

Colder temperatures and central heating have the tendency to suck the moisture from your skin, the Bioderma Hydrabio Masque and Serum restore the lost moisture back into the skin.

Don’t delay…

Last date to place your orders to receive them before Christmas

Bioderma, Noreva and Mustela: 15 December 

All other brands: 10 December

Orders placed after these dates will be shipped in January 2019.


Merry shopping!



Dr Levashni Naidoo: Treating pigmentation in summer

I have a complicated relationship with summer: I love feeling the warmth of the sun on my skin, but I don’t love the unevenness with which it marks my complexion.

With summer’s seasonal return, I’ve learned that the sun usually kisses and tells. This can be concerning to those affected by pigmentation problems, so let us look at common factors that may worsen your excess pigmentation and follow our tips to help you with this challenging condition.

Why treat pigmentation?

I’ve treated many patients with pigmentary disturbance. I’ve seen their frustration at having to cover up a condition they wish they could rather spend time improving medically. I’ve witnessed the anxiety they face at the idea of going make-up free. I’ve come to understand the difficulties they face in terms of lowered self-esteem and how self-conscious they feel following the onset of unexpected pigmentary alterations.

Pigmentary disturbance remains a challenging condition to treat. There are over 152 genes that regulate pigment production! This has an impact on how individuals respond to topical treatments, and finding the correct treatment is a process.  It is important to understand that there is no quick fix. I do, however, believe that if dermatologists work closely with our patients, we may embark on a pathway to improvement.

The skin complexion we inherit is influenced by

External Factors

Sunny Days

South Africa is amongst the sunniest countries in the world and sun-induced pigmentation ranks first as both cause and aggravator of many pigmentary disturbances. We all understand that ultraviolet UVA and UVB rays cause photoaging (sun-induced ageing) and increased pigment production. But we also realise now that the visible light spectrum and infrared radiation play a significant role in contributing to skin damage and uneven skin tone through generation of reactive oxygen species (free radicals) within the skin.

Sun exposure may lead to a general increase in pigmentation where skin is exposed, as well as a darkening of pre-existing freckles and the appearance of sun spots.

Heat Waves and Close Shaves

Heat itself from any external source or trauma to the skin may stimulate increased activity of melanocytes (pigment-producing cells in the skin.)

Internal Factors

Heavy-handed hormones

Melasma (hormonal hyperpigmentation) is a common form of pigmentary disturbance. It frequently occurs during pregnancy or when a susceptible person starts using a combined oral contraceptive pill. The increase in oestrogen concentration stimulates melanocyte activity, increasing the production of melanin. This increased pigmentation is commonly found on cheekbones, forehead, nose and occasionally around the mouth.

The aftermath of inflammation

During the active phase of many inflammatory skin disorders – such as acne, eczema and lichen planus – inflammation in the skin may activate pigment production pathways. When the skin is healed, there may be an increase in pigmentation, called post-inflammatory hyperpigmentation (PIH).

Popping pills

Certain types of medication may lead to pigmentary disturbance. These include non-steroidal anti-inflammatories used for pain relief, the combined oral contraceptive pill, antihypertensive (blood pressure), antimalarial, antibiotic and anti-epileptic medications. Telltale signs that you may have drug-induced pigmentation include darkening of your nails and mucosa (lining of the mouth, etc.).

Should you treat pigmentation in summer? Yes!

Treatment of pigmentation has two arms:

One: use one or a combination of treatment agents that effectively decrease pigment production and,

Two: prevent further worsening of pigmentation from continued sun exposure.

The most important aspect of treating pigmentation over sun-exposed sites is to ensure that you protect vigilantly from the sun.

  • This includes avoiding peak-intensity sunlight hours between 10 am and 3pm outdoors.
  • When you’re outdoors, wear protective clothing in the form of sun hats, scarves and long sleeves,
  • Always remember to apply a broad-spectrum sunscreen with both UV, visible light and infrared radiation protection, such as Bioderma Photoderm range


What treatment should you use?

Here are your A, B, Cs for treatment of excess pigmentation in the summer months:


Always use sun-protection. A broad-spectrum sunscreen should be applied daily in appropriate quantities (a R5 coin amount for your face alone). Re-apply every couple of hours if you are spending time outdoors. Remember, no sunscreen lasts the entire day.

Always remove pigmentation-stimulating agents, such as exacerbating drugs. Speak to your doctor about changing medication, if possible.


Brightening agents

Dermatologists may use the following in-clinic treatments to reduce pigmentation:

Chemical peels containing alpha-hydroxy acids like glycolic acid. The strength of the peel will depend on what is clinically suitable for your skin type to minimise inflammation, especially in those with darker skin types. Peels should gently encourage exfoliation of the uppermost layer of the skin, lifting epidermal pigmentation and helping active brightening ingredients from skin care products to penetrate the skin.

Dermafrac is a newer treatment combining microdermabrasion, micro-needling, simultaneous deep tissue serum infusion, and light emitting diode (LED) therapy. In addition to stimulating skin rejuvenation, the procedure also helps with uneven skin tone and hyperpigmentation through delivery of select ingredients into the dermal layer to damp down pigment-producing pathways. This procedure is particularly recommended for those with darker skin types. where stimulation of inflammation through more aggressive treatments may actually worsen pre-existing pigmentary disturbances.

Laser therapy should only be carried out under the care of trained medical professionals. The selection of laser is dependent on the cause of the pigmentation, with careful consideration given to the skin type of the patient.


Care at home

In cases of chronic hyperpigmentation, a more intense acute phase of therapy is often followed by a tailored, safe long-term management programme. Treatment in the acute phase may include ingredients like hydroquinone that are prescribed for a short period under supervision of your dermatologist.

Due to side-effects with continued hydroquinone use, a switch to a non-hydroquinone- based ingredient or combination of ingredients is advised.

Skin brightening agents work on various different pigment activities:

  • they may block the formation of melanin,
  • inhibit the transfer of melanin from the melanocyte to other skin cells,
  • suppress melanocyte activity
  • limit inflammation and
  • enhance skin cell turnover


Systemic skin-lightening agents have become increasingly popular in recent years. Fernbloc has proven safety and efficacy, but we strongly advise against using other agents such as intravenous glutathione because of severe side-effects, which include renal and liver impairment as well as documented life-threatening adverse drug reactions including Steven Johnson Syndrome.

My recommendations for home care treatment of pigmentation and sun protection

  1. Essential: Sunscreen with a broad- spectrum UVA and UVB cover, as well as cover for visible light. I recommend Bioderma’s Photoderm M  if you have been diagnosed with hormonal melasma as it effectively extends cover to this visible spectrum range. Sun protection is especially important if you have had in-clinic treatments and are using active ingredients such as hydroquinone, retinol, AHA, etc.
  1. Noreva Trio White depigmenting range  is a combination of reductol (a phytonutrient that protects keratinocytes), as well as vitamin C and arbutane that limit melanin production
  2. Esthederm’s Esthewhite range: a combination of murine exopolysaccharise that enhances skin cell turnover, glucosamine and glabridine that regulate melanin production, and vitamin C with added anti-oxidant benefit.
  3. Topical retinoid at night: For first-time retinoid (vitamin A) users, I start with Esthederm’s Intense Retinol Serum – a 0.3% retinol preparation combined with papyrus and apricot oils rich in omega 3, 6 and 9, which improve tolerance of the retinoid. As you develop tolerance, and should added strength be required, I upscale treatment to a prescription-grade retinoid.

Find out more about the Esthederm range here.

Here’s wishing you happy summer days,      


Dermatologist Dr Levashni Naidoo





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