Glutathione (GSH) either as oral supplements or IV drips as skin lightening agents are the go-to treatments for glowing and bright skin especially in Asian countries and India, where the quest for fair skin is a never ending journey.
In this post we will see what glutathione is? Does it work as a skin lightening agent ? Are there any studies to back up its use in beauty spas or clinics? Is it safe? And is it worth it?
The evidence for oral or topical glutathione for skin lightening is still not convincing yet to warrant a unanimous recommendation for skin lightening or as a treatment for pigmentation
Is there a way to naturally increase GSH stores in our body?
YES you can.
The most economical & sustainable way to prevent glutathione depletion in our body is by preventing the need for GSH in the body in the first place by reducing oxidative stress.
Lifestyle habits that one can make to reduce oxidative stress :
Limit alcohol consumption
Quit smoking
Diet rich in fruits, vegetables and nuts which delivers amino acids required for GSH production or rich in other antioxidants : Tomatoes, oranges, spinach, asparagus, avocado, berries, walnuts, almonds ( best consumed raw or lightly steamed)
Whey protein is a good source of cysteine (an amino acid essential for GSH synthesis)
Pregnancy, one of the most beautiful journey for a women, but it can be associated with many skin changes that can be bothersome and add unnecessary stress during this time.
These changes in the skin, hair or nails are normal and expected, but the good news is, they are temporary and resolve spontaneously post delivery to a great extent even if not completely to a pre pregnant state. Let’s look at what these changes can be and how you can address them.
Hyperpigmentation
This one of the most common change that can see seen in upto 90% of pregnant women. It is more pronounced in women with brown to darker skin type. Body folds, or areas of the body which are normally pigmented such as the under arms, inner thighs, become more pigmented. For some women, diffuse hyperpigmentation can occur.
Such pigmentation does not require any treatment but if one is concern and wants to address it then one can use some product such as lotions, toners etc. Be careful not to overuse AHA’s (gycolic acid) the the underarm areas.
Melasma
Another common pigmentation issue that develops during pregnancy.
Which skincare are safe to use during pregnancy?
Most skincare, be it moisturisers or serums or sunscreens (chemical or physical) can be used safely during pregnancy.
Experts often recommended limiting the amount of exposure to or avoiding certain ingredients as a precautionary measure and not because the ingredient is harmful to the mother or the developing baby.
Hydroquinone (HQ) can be substantially absorbed into the blood stream when applied topically to the skin. Even though there have never been reports of it causing any adverse effects to the baby when used during pregnancy. It is still recommended to limit one’s exposure to HQ or avoid it during pregnancy.
Retinoids are recommended to be avoided during pregnancy based on the evidence that Oral vitamin A analogues when taken orally during pregnancy can cause birth defects in the developing baby. And as topical retinoids are also vitamin A derivatives, it’s recommended to avoid using them during pregnancy if possible just as a precautionary measure. There is no evidence to suggest that one needs to discontinue topical retinoids if one is trying to conceive.
If you are conflicted with making a decision on whether to avoid such ingredients or continue using them in you routine during pregnancy, it’s best to discuss this with your treating dermatologist and gynaecologist who can help guide you make the decision that is best suited for you individually.
Stretch marks
When it comes to preventing pregnancy stretch marks or reducing their appearance, there are not much options out there and most products available in the market that promises otherwise do not work.
The use of products containing cantella asiatica or silicones or hyaluronic acid have some weak evidence that they may help with the appearance of the stretch marks when applied regularly. However these are not miracle creams, you may still develop stretch marks despite using such products regularly.
If you want to try such products, go ahead, just make sure to spend some time massaging the products into your skin as the increase blood circulation to the skin as a result of the massage may be able to help to some extent and set realistic expectations so that you do not get disappointed.
Oils such as rosemary oil, olive oil, cocoa butter, shea butter have never been proven to help.
We’ve all heard of acids such as glycolic acids, and if you’re acne prone- salicylic acid and the rest. These acids are used in skincare products as chemical exfoliants i.e they help to chemically detach cells in the upper most layer of the skin from one another, yielding a more youthful, smoother, brighter skin.
What are the various types of acids used in skincare ?
How do they work?
Lower strength acids as found in OTC cosmetics (usually <10%) works at the level of the epidermis specifically at the stratum corneum (upper most layer of skin) and causes exfoliation.
Higher strength acids (>20%) are used as in-office procedures by professionals as chemical peels. Higher strength and lower molecular size acids such as glycolic acid can penetrate deep into the skin (upto the dermis) to boost collagen, GAG’s production thereby increasing the thickness of skin, and reversing signs of photoageing such as wrinkles, deep lines, sun spots etc.
Concept behind exfoliation
As we age our skin cell turn over (cells from the lower layer, divide and mature and are eventually shed off) slows down. As a results more cells from the startum corneum accumulate on the surface which gives aged skin a more dull, and rough appearance. Chemical exfoliation using acids helps speed up the process of shedding the upper layers of the skin. Hence, incorporating acids in our skin care are of benefit a we age and and for addressing certain skin concerns. They are un-necessary for younger age groups as their skin can naturally exfoliate at a good rate.
Rough estimate on the average skin cell turnover with various age groups
Acids beyond exfoliation
Uses of acids in skin care products can be more than just for exfoliation. Different acids have a slightly unique properties that help address specific concerns.
How to choose a chemical exfoliant?
Firstly, not everyone needs a chemical exfoliant in their routine. If you do not have any skin concerns, or if you are happy if your existing routine, continue what works for you regardless of whether you have such acids or not in your routine.
Amongst AHAs :
Glycolic acid is most commonly used and widely available in skincare products. However being of smaller molecular size, it can penetrate the deeper layers of the skin and cause irritation for some.
Lactic acid: another common AHA, but has additional properties of being able to retain water thus hydrating the skin. It’s also less irritating as compared to GA
Mandelic acid : a larger molecular weight AHA that is great for people not tolerating other acids or for people with sensitive skin as it is least irritating.
PHA and PBHAs, the newer generation acids. Not only do they provide gentle chemical exfoliation, some PBHAs such as lactonionic acid help hydrate and soothe the skin.
Note: The tolerability of such acids are also dependent on the overall formulations. Some products have a combination of these acids for maximum benefit and least irritation. Most often you only require a single product, and try not to use too many chemical exfoliants in your skin care routine without a professional consultation.
Irritation is the most common side effect of using such products. It can present as redness, burning or itching. It can also be seen as bumps resembling acne. Start by using such products just once-twice a week instead of every night and do not forget your sunscreen.
Some people may be allergic to certain acids, always perform a patch test prior to using such products especially if you have sensitive skin.
Over exfoliation can disrupt your skin barrier, making it sensitive, dry and irritated. In this case, stop using such chemical exfoliants and jut stick to the basics: cleanser, moisturiser and sunscreen.
If you already have a routine for your acne or pigmentation, please consult your dermatologist prior to incorporating such products in your routine.
Dark circles though very common, can be difficult to address. Many factors are involved in causing dark circles, such as ethnicity, bone structure, anatomy of the skin etc, and most times a cream or serum cannot address all the factors involved, thus resulting in failure of treatment.
Let’s try to understand more about dark circles here.
What causes dark circles ?
There can be intrinsic factors (internal, genetically predetermined factors, inevitable) or extrinsic factors (external, environmental impact, modifiable).
These factors are non modifiable and most topical products such creams/serums cannot completely address these factors
Extrinsic factors can be modified to reduce the risk of developing or worsening of dark circles
Types of dark circles
Understanding the type of dark circles helps guide the treatment options.
So you have been using eye creams religiously for a long time and you still have not seen results. Why isn’t t it working for you?
Lack of sun protection: The under eye area is a commonly missed site during sunscreen application.
Not making the necessary lifestyle changes: Ongoing stress, lack of sleep, not cutting down on smoking and alcohol.
Underlying cause not addressed: Continuous scratching from eczema irritation.
Lack of patience: Depigmenting creams take time to work
Incorrect choice of product or treatment: Some form of dark circles benefit more from prescription medications or from a combination of products + in office procedures such as fillers, chemical peels etc
Unrealistic expectation: No creams/serum can 100% reduce dark circles. Shadowing effect due to bone structure cannot be corrected by creams. Constitutional pigmentation respond only minimally to OTC products.
Oily skin medically done as a “Seborrhoea”is described for skin that feels greasy, looks shiny usually, have large open pores which is also prone to acne and though viewed as a cosmetic concern, what is skin can have a negative impact on one’s confidence and mental health.
Oily skin is such a common concern for many that the beauty and skincare industry are constantly preying on this concern launching products with highly unrealistic claims and marketing strategies with labels such as “oil free’ , “oil control” etc while hero-ing ingredients that have never actually been proven to help regulate oil production at all.
This post will hopefully help you understand more about what oily skin means: that anatomy, physiology, the function of sebum (oil) in skin, why one has more oiler skin than other with a mention on products that can actually work help reduce skin oiliness.
More about sebaceous glands and sebum
What causes oily skin?
There are many factors that contribute to oily skin.
Can oily skin be treated ?
Though oily skin cannot be completely cured, there are certain treatment options that could help control the skin as well as some causes a suitable that is over-the-counter products that may be able to help with its appearance.
Seek professional treatment from a dermatologist if you only skin is really affecting your self-confidence and your mental health or if over the counter products fail to achieve the desired results. A professional consultation will also help rule out certain medical conditions, which would otherwise require further investigation and treatment
Look out for these ingredients in over the counter products :
Salicylic acid, Niacinamide, Green tea extract, L-carnitine
Though these ingredients do not have a very solid scientific data, there are some small scale studies that have shown that they can help address oily skin
Post acne erythema are also called post acne erythema or macular erythema.
They are persistent pink to red marks that occurs in acne patients during the course of acne treatment and persists for sometime even after the acne subsides.
They are more commonly seen in patients with lighter skin (FST I-III), but PIE can also be seen in Indian skin type FST III & IV as well.
PIE is a relatively new term, which is different from post inflammatory hyperpigmentation (PIH) i.e the brownish black scars that follows an acne eruption.
Difference between PIH and PIE
How and why does PIE occurs?
Still not clearly understood. Potential explanation is that during the process of inflammation, some pro-inflammatory cytokines that are released causes dilatation of the small blood vessels present in the superficial most part of the dermis.
The epidermis while still being in the process of maturation, is thinner, more transparent and can thus more incident light is reflected from the underlying vasculature
So far, there is not much options for treating PIE.
The best approach is to minimise the risk of developing PIE in the first place.
As blood vessels will dilate during the process of healing, so some amount of erythema (redness) is expected. However as persistent inflammation is the driving force for long lasting erythema seen as PIE, addressing the factors that causes the inflammation will help minimise the chances of developing persisting PIE.
You do not need to buy products with these individual ingredients separately. Just look for products formulated with these ingredients together either in your moisturiser or sunscreen
Treatment that have been tried for PIE
For most individuals with acne, PIE subsides spontaneously after a few weeks to months just with gentle, supportive care in the form of sunscreens, moisturisers +/- ingredient to help with the inflammation.
However for some, PIE can be persistent even with the above measures. Medical management that have been tried include topical creams and different types of LASERS.
There is still no standard treatment for PIE and large scale studies are still lacking
So far, LASER treatment is still the best option for persistent PIE
As I was growing up I’ve seen my mum and most of my aunts trying in vain every remedy available for the pigmentation on their face
What is melasma?
Melasma also called cloasma is a common acquired hyperpigmentation disorder affecting mostly women in their reproductive age groups (~15-45 years) . It is the most common pigmentation disorder & is seen more commonly especially in individuals with darker skin type (FST IV-VI) affecting 9 -50% of the such high risk population . (Find out your skin type here)
What causes melasma?
Cause of melasma is multifactorial and factors such as UV radiation, elevated estrogen (female hormones) level work together to result in melasma in genetically predisposed individuals
Genetics: Certain genes are responsible for up regulating enzymes in the melanogenesis pathway (process of melanin production) which results in more melanin production.
UV Rays: Increase production of reactive oxygen species, which can then increase tyrosinaseactivity.
Hormones: Estrogen can up regulate enzymes (tyrosinase) and genes in the melanogenesis pathway, resulting in increase pigment production in genetically predisposed individulas.
How does it present?
Melasma presents with tan brown reticulate (lacy) pigmentation described in three distinct pattern on the face.
Centro facial pattern: Most common pattern affecting the forehead, nose, upper lip, chin and cheeks
Malar pattern : As seen in the below images affects the malar area (cheeks) of face
Mandibular pattern: Affects the jawline and chin, mostly seen in late onset melasma
Melasma in women can present for the first time in pregnancy and its referred to as “Mask of Pregnancy“. Treatment of which is more difficult because of the increase estrogen level in the body and as most medications used for pigmentation may not be safe during pregnancy.
The good news is that in some women, this mask of pregnancy is transient and will fade with time and proper management.
Can melasma occur in males?
Yes, melasma can occur in males as well. The male to female is ratio 1:9 i.e for every 9 females with melasma, 1 male individual also suffers from melasma. It has also been reported to have a higher prevalence in Indian males compared to Caucasian males.
Does melasma occur elsewhere besides the face?
Yes, rarely it can involve the neck, chest, the upper arms or forearms and it’s called “Extra facial melasma”
How is it diagnosed?
Most of the time a dermatologist can diagnose melasma by just examining it.
A wood’s lamp examination may be used to assess the dept of the pigmentation i.e if it is epidermal (superficial) or dermal (deep) pigmentation. Epidermal pigmentation respond to treatment better.
Occasionally a skin biopsy (examining of a skin sample under a microscope) may be required for a definitive diagnosis as all facial pigmentation is not melasma.
Treatment options
The hunt for the cure for melasma is still ongoing.
Though numerous treatment options are available now, there is still no “one product” that does it all.
The mainstay of treatment is avoiding the factors responsible for it as much as possible. Since one cannot change one’s genetic makeup, taking measures to avoid the modifiable factors (such strict sun protection) will help prevent its occurrence and reduce the appearance of an already developing melasma.
Its always good to know your personal risk of developing melasma so as you can actively prevent it from occurring in the future.
If melasma is highly prevalent in your ethnic group (for eg: melasma is highly prevalent in my hometown i.e Shillong, Northeast India) start taking preventive measures at the earliest. Its best to consult a dermatologist as early as possible at the start of the pigmentation rather than after a trail and error of using multiple self prescribed creams and remedies.
Shillong, though blessed with its hills, rivers, waterfalls and clouds, being at a higher altitude (1525 m above sea level) means it gets more UV rays than lower altitude areas and the cloud cover aids in scattering these UV rays. Understanding these facts will help individuals be more aware of the need of sun protection even in cloudy, pleasant days without the sun shining bright.
The first step to the treatment or prevention of melasma is strict sun protection. No creams, chemical peels or LASERS will effectively work if one is not complaint with this step
Gel formulation or matte finish for those with oily skin
Apply to both face and neck at least 20 mins prior to sun exposure and reapply every 2 hours especially when outdoors
Sunscreen application should be on all days even when the sky is cloudy or rainy
Use a sunscreen even when indoors (as glass cannot filter UVA light)
Other measures of sun protection include using a wide brim hat during your outing tot he beach or during any outdoor activity.
Avoid the peak hours of the day such as between 12 noon -2 pm when the sun is directly above the earth.
Seek shade whenever possible
Treatment to reduce pigmentation
Now that we’ve had sun protection covered, you will need to seek expert opinion (dermatologist) for further management as there are many active ingredients available for treating pigmentation and not everything is suitable for everyone.
If you are on medications such as oral contraceptive pills containing estrogen or drugs for seizures such as phenytoin which could be the potential cause of the melasma, then its best to speak to your treating physician for a possible changeover of the medications.
What are the treatment options available?
To understand how the treatments work, we first need to have an overview of how melanin (pigment responsible for our skin, hair, eyes colour) is formed.
Melanogenesis i.e process of melanin formation in melanocytes (cells for melanin production). The 3 main types of melanin are eumelanin brown, eumelanin black & phaeomelanin (yellow red). Humans have all 3 types but the ratio of each type of melanin is different in different ethnic group. For eg more pheomelanin is present in red heads with pale fair skin, more of brown eumelanin is seen in blondes and more of eumelanin black is seen in brown-black skin type with black hair.
Topical medications for melasma
Various options are availabe in the form or creams, ointments or serums and the choice will differ from patient to patient.
Topicals required long term and consistent use for the best results.
Not every option will work for everyone
Some of the active ingredients that are use to reduce pigmentation are enumerated in the tables below:
There are numerous options for the treatment of melasma, and the choice will depend with every patient.
For best results, sun protection, strict compliance and abundance of patience is required as improvement can only be appreciated after months of consistent skin care routine.
Oral medications for melasma
Trenexamic acid – An anti fibrinolytic drug that prevents the breakdown of protein (fibrin) present in blood clots. Therefore it is traditionally used to treat bleeding disorders.
It has been shown to be effective for the treatment of melasma in low doses. It has been show to produce results in 3 months but relapse rates are high and melasma recurs within 3 months of discontinuation of the drug.
Side effects are nausea, vomiting & serious side effects such as heart attacks, blood clots in veins of legs, renal injury (kidney problems) could potentially occur in individuals at risk.
Chemical peels
Dermatological procedure where acids of higher strength is used such as glycolic acid, salicylic acid, trichloroacetic acid etc are applied to the face or pigmented area by a dermatologist for a short contact time.
The procedure is done every 3-4 weeks for 5-6 sessions depending on the patient’s response.
Second line treatment for those not responding to topicals alone.
Expensive and requires an experienced hand.
LASER for melasma
Various types of LASER are available for the treatment of melasma.
LASER treatment can be tricky especially in individual’s with darker skin type as the risk of pigmentation is higher. LASER are usually reserved for resistant cases not responding to the above mentioned treatment options.
LASER are not one time treatment. Creams and sunscreens will still be required to maintain the result and prevent recurrence.
LASER treatment are expensive but may be worth it when done by experienced hand.
There is still no cure for melasma.
Seek guidance from a dermatologist as the appearance of the pigmentation can be improved with either depigmenting creams & sunscreens or a combination of treatment especially when the treatment is started early.
We have all, at one point in time, dealt with excessive hair fall that alarmed us enough to either self treat with DIY/home remedies or to seek a dermatologist’s opinion.
Let us understand the normal physiological process that our hair goes through which is called “Hair cycle”.
Hair cycle is divided into 3 main phases :
Anagen (90% of the hair are in this active growing phase ) which proceeds to:
Catagen (resting phase), which then progress to :
Telogen (regressing phase)–> the hair then eventually falls out (exogen) as the hair follicle enters a new anagen phase.
As you can see that as new hair grows, the existing hair in that particular hair follicle has to fall out. So hair fall should not necessarily alarming, and this normal hair shedding is seen to be 50-100/day and in some individuals it could be upto 150/day as well.
When to seek a dermatologist’s opinion?
When the hair fall exceeds what was mentioned above, or you start noticing recession of the hair line or thinning of hair in crown (in men), thinning of the hair and a more visible scalp along the part line (in females), or patches of hair loss.
Common causes of hair loss:
1. Telogen effluvium: Presents with a more diffuse hair loss of >150/day. Occurs 2-4 months after any systemic illness such as infections (malaria, typhoid etc), childbirth, surgeries, crash diet, thyroid disorders, psychological stress etc.
The condition is completely reversible and the hair loss starts improving in 4-6 months once the underlying factor is corrected.
Female pattern hair loss
2. Androgenetic alopecia ( also called male pattern baldness or female pattern baldness in men & women respectively due to the characteristic pattern of hair loss). It is genetic disorder, in which susceptible hair follicles either have a higher response to the hormone testosterone, or have a higher amount/activity of the enzyme ( 5 alpha reductase) which converts testosterone into a more active form.
Male pattern hair loss
This result is the normal terminal hair (thick , black scalp hair) is transformed into vellus hair (thin, fine, light coloured hair mostly found in other parts of our body).
The overall effect is gradual thinning of hair. The disorder can be inherited from either maternal or paternal side
Image: DermNetnz
3. Traction alopecia:
Caused by the excessive constant stretching of the hair shaft from hair styling such as tight braids/ ponytails
4. Alopecia areata: Considered an autoimmne disease normally seen in children and presenting with localised patches of hair loss, rarely it can affect adults and be of a more diffuse nature.
Usually self limiting i.e hair regrows back even without treatment.
There are more causes of hair loss, but the ones mentioned above are the commonest ones experienced by individuals.
Treatment for the different types of hair loss may vary with some requiring no specific treatment at all such a telogen effluvium whereas others have specific therapy such as alopecia areata and androgenetic alopecia.
As a dermatologist, I’m a firm believer in evidence based medicine. We study dermatological issues and their treatment options throughout our training. We study molecules used in skin or hair care products religiously, reading the research available on them, which active ingredient works, how they work, the dosage, their benefits and side effects and how effective they can be for a particular condition.
Therefore, I personally do not advised nor can I validate the popular culture of “DIY” (do it yourself) or home remedies for skin or hair care.
Yes, dermatologist keep saying that the basics to skin care are ABC (Vitamin A, Vitamin B, Vitamin C), and many of the active ingredients used in skincare are plant derived, this can be confusing to many of us. One can find the “ABC’s” easily in one’s kitchen, pantry, or garden so why shed your money buying expensive products containing the same?
Let me break it down for you in simple terms:
The skin has three layer, the epidermis (uppermost), the dermis (middle) and the subcutaneous tissue (fat and lowermost). the diagram on the right is the epidermis, which is composed of several layers.
The upper layer of the skin (epidermis) is described as resembling a “brick and mortar” structure.
The main function of the skin is acting as a barrier, protecting our body from various environmental substances and it does a pretty good job at it too.
This means many of the DIY’s of tomato paste, lemon juice, etc may not even be able to reach the inside of your skin through that “brick wall” to perform the functions you are expecting them to do.
This is why we have well formulated creams, ointments, serums etc because they contain other agents that help deliver the desired active ingredient (be it vitamin A, B or C etc) to cells in the skin.
Secondly, vitamins are present in various forms, for example for vitamin A we have beta carotene, retinol, retinal, and the most active form retinoic acid. Retinoic acid is the one that binds to receptors present in the cells of our skin to bring about beneficial changes such as anti ageing, anti acne etc.
Simply applying a paste of vitamin A rich fruits such as papaya does not achieve the same result, because vitamin A in fruits & vegetables are in the form of beta carotene.
Thirdly, DIY,s could potentially be doing more harm than good. A common example is a condition called “PHYTOPHOTODERMATITIS” where patients develop an irritant dermatitis when the skin is exposed to certain plants/citrus fruits and sunlight.
Patients develop a red rash on areas of exposure, burning sensation and may develop fluid filled lesions as well. The rash would then heal with pigmentation.
Left image is also called “Margarita burn” -phytophotodermatitis due to the limes present in a margarita cocktail followed by sun exposure. Right image– pigmentation left behind when the irritation subsides.
Just because DIY/Home remedies are all natural does not necessarily mean they are completely harmless and safe
Lastly, even though some skin care products use active ingredients such as various forms of vitamin A, B or C, they have been extensively researched in the labs, animal and human studies. Scientists study the active form of these vitamins, the strength at which these ingredients that have been proven to be effective to produce a desired effect (eg: niacinamide- vit B3, strength of at least 4 % works to reduce pigmentation, repair skin barrier, vitamin C of 20% works as an anti-oxidant, anti ageing, salicylic acid of at least 2% helps unclog pores and so on and so forth).
Simply grinding vegetables, or whisking eggs making a paste for your skin, is not going to achieve the same result
How does one know the strength of the vitamin present in that paste?
Yes, Cleopatra may have bathed in milk to maintain a beautiful youthful skin. We now know that milk has lactic acid which helps in exfoliation of the skin, and we have products designed particularly for that now with or without lactic acid, so people wont have to be bathing in milk for a glowing youthful skin.
The only time dermatologist advised on using ingredients available at home is for coconut oil. We advised coconut oil application for patients with conditions causing dryness of their skin, who are not able to afford regular moisturisers.
Consuming fruits and vegetables provides you with more nutrients that can be beneficial for skin & hair rather than external application of various DIY concoctions of eggs/lemons/mango etc
I’ve been slacking with creating new content for the past few months, its been difficult to find the motivation sometimes especially when one is dealing with a million other things. But now with this pandemic going on, countries are facing global lockdowns and being a dermatologists and not someone working in the front lines of this health crisis, I now have more time to dedicate to this blog again. And I hope you’re all safe and well wherever you are.
As my first posts in months, I’ve decided to share something more on a personal note and not too much of the normal “science behind skincare” content I normally post.
I was lucky enough to be able to have a wedding reception in Goa recently in February 2020, just before this pandemic shook the world by storm.
I’ve been requested to share by professional advise on skin care for the upcoming brides out there. I was honoured to be featured by https://hitchedhaven.com/ (a website catering to future brides & grooms seeking to tie the knot in goa) on their website about my skincare advises as a dermatologists for “that wedding glow”.
Here are some pictures without makeup.
And the pictures from the wedding:
As a dermatologist skin care is my expertise. I’m a firm believer and advocate of evidence based consistent skin care regimen which means I use products backed up by science and I do not resort to DIY or home remedies for my skin or hair.
You plan for your wedding months ahead, similarly your skin needs the same amount of attention months prior to the big day.
Seek a consultation with a dermatologists to help formulate a skin care routine addressing your personal issues (be it acne, or pigmentation etc). Its important to start this early as there is no “fast track treatment” for such issues yet except for the magic of makeup, which can conceal anything. But if you’re someone like me who does not like wearing too much makeup and want to keep things as subtle and natural as possible then:
Find a dermatologist before you find a makeup artists.
If hydrated, clear, glowy skin is your goal without having to worry about the thick layer of makeup on your face for your wedding day especially if you’re planning to have a destination wedding in the humid climate of goa, here are some advises for you:
Use a broad sunscreen with both UVA and UVB protection. Search for one with spf 30 and above with a PA factor of +++, this will help prevent sunburns and tanning which makes your skin look dull. If you want help with your choice of sunscreen, check out my previous post: https://drnaphi.com/2019/07/15/all-about-sunscreens/
You may opt for sessions of chemical peels which helps with pigmentation and gives you a glowy youthful skin. Chemical peels are out patient procedures performed by certified dermatologists in their clinics. Higher strength acids such as glycolic, salicylic, or trichloroacetic acids etc are used in multiple sessions of 2-3 weeks apart, to help achieve a clearer skin.
Always use a moisturiser. And yes, you still need a moisturiser even if you have oily acne prone skin, and its especially important if you’re using an active ingredient for your acne such as retinoids, benzoyl peroxide etc. I have acne prone skin and below are some of my favourite moisturisers:
Facials, clean ups are optional, but if you want that extra layer of pampering, then don’t wait till the day before to do it. The reason being, in case you do experience some allergic reactions from any of these products, your skin will have the time to heal. Do it a week before the big day and maybe just use face mask sheets for the instant hydration the night before.
Your skincare does not end on your wedding day.
Remember to wash your face thoroughly after the celebration. I know you’re going to be tired after at the end of the night but trust me, you need to get that makeup and sweat from the entire day off your skin before you take your final rest.
Use a micellar water or cleansing oil as the first step to remove all the oil based makeup. Then clean your face with any cleanser after.
My go to micellar water, but there are so many other versions out there in the market. You can use any one of your liking.
Cleansers I swear by, and its not just for this special day, I use them on a regular basis.
Dr Naphisabet Wanniang 
