28 Comments
Sep 24, 2023Liked by Michelle Lee

I may have to try tret. I’ve been using retinal, but eventually I’m going to need something stronger.

Expand full comment
author

Highly recommend!

Expand full comment

I am going to try this from Musely. I have been trying endless amounts of creams because I'm too chicken to do lasers!

Expand full comment
author

Yeah Musely has been a big game-changer for me. Let me know how you like it and feel free to message me if you have any questions!!

Expand full comment

Thanks so much for your reply! Can you tell me which creams you did get? I wonder if I should get the ones for my neck too since I have some dark spots there:(. The woes of getting close to 50:(. Also love your substack:). Such good info on there:).

Expand full comment
author

I used Spot Cream and Anti Aging cream (veteran formula which was too strong to start with and my dr did warn me). I tried neck but fully admit I got lazy and didn’t stick with it!

Expand full comment

Ok great thank you so much!

Expand full comment

I’ve been on the tret/hydroquinone train for the last year for my heat activated melasma. It does wonders!!! Also great for wrinkle reduction!

Expand full comment
author

Yes!! It's really amazing and I'm kind of upset at myself that I didn't try it sooner. I wanted to start a few years ago but was pregnant so I had to wait. Do you do anything else since your melasma is heat-activated? I do know that some people try to cool their faces down with ice rollers or even a bag of frozen peas if they're getting hot. We got a pizza oven this summer and I was like, ok, I'm not gonna keep my face in front of that thing for too long haha

Expand full comment

I rinse with mostly cool water these days. During this super hot July and I worked from home, I wore a lot of my workout clothes during the day to stay cool. It's hard to know exactly what heat source makes my face react! Noted re: the pizza oven. I need to step away from the air fryer!

Expand full comment

Also I think you might have finally convinced me to try Tret.

Expand full comment
Oct 1, 2023·edited Oct 1, 2023Liked by Michelle Lee

I did HQ and Tretinoin. Now I do Tret .1% and Azelaic acid. It took 3 months to move the needle on PIH, but about a month to get my skin plump and juicy. I use Nurx

Expand full comment
author

while you're doing it, it can feel like it's taking forever but 1 mo and 3 mos is really impressive! that's great.

Expand full comment

I had done Tret and HQ for a year before the Azelaic acid so I had a head start, but I think the AA really made a difference. Maybe because I don't have to do a month on and a month off like with the HQ. Now to find a great sunscreen.

Expand full comment

Thanks for sharing this. I didn't realize you could use tret on top of moisturizer, so I'll definitely try that along with adding hydroquinone to my routine. (Also, welcome to Substack, Michelle!)

Expand full comment
author

Yup! There are lots of methods for buffering. You can sandwich the tret in between layers of moisturizer or just put it on top. It does make it slightly less potent but buffering can help you acclimate

Expand full comment

I was going to say!! sandwiching is life. moisturizer (or a nourishing serum) before and after application really makes a diff as you build tolerance

Expand full comment

I started using tretinoin just 2 years ago and have slowly increased the strength. And I agree - it works in so many ways. Definitely noticed a fading of brown spots on my face and hands. Now I need to try hydroquinone! Maybe that will finally rid me of the spots (fingers crossed).

Expand full comment
author

It’s really a lifelong thing unfortunately. Once you fade the dark spots you still have to keep working at managing it. I’m so jealous of people who don’t have hyperpigmentation!

Expand full comment

need to send you a few things I think you would like! for Am/Pm

Expand full comment
author

Pls do!!

Expand full comment

I've tried tret forever and I can never get over the hump of dry flaky skin, even when just trying to build up to twice a week. How long did it take for your skin to acclimate and did you work up to everyday? I've done many of the same treatments as you - but for acne scars rather than dark spots.

Expand full comment
author

Oh it is tough to figure out! I'll be honest, even though I've been using it for a while, I STILL randomly experience the dry/flaky skin sometimes. It took me at least 3 months of experimentation, trying to figure out how many days a week I could do the tret, how much and how to buffer. You could also try a lower percentage. But I definitely don't do every day and that's ok, from what I understand. I'm more every other night or every 2 nights, depending on how sensitive my skin is feeling. I have so many thoughts on tret I didn't include. This definitely makes me think I need a whole post just on that!

Expand full comment

Loved this so much. Also I'm sure you know her, but Dr. Sam @ Facile is legit the melasma whisperer and is doing really interesting things in the space. Facile's Brighten serum has been good for me. I also weirdly swear by iS Clinical's Active Serum; it helped my insane heat-activated forehead melasma. (Ah the probs with working out in a heated room.)

Expand full comment
author

Ooh I don't know Dr. Sam yet but will definitely seek her out. And yes, melasma folks need to be careful around heat: hot yoga, saunas, even standing in front of a grill or stove/oven for too long. I've become more conscious about my heat exposure lately. The struggle is real! The unfortunate part about melasma is that it's truly a lifelong thing. People expect that you fade it once and it's gone but because it's sparked by hormones and heat and other things, it never really leaves us. It's just something we can learn to manage as best we can.

Expand full comment
Sep 24, 2023Liked by Michelle Lee

Hi, Michelle! Can you share more about the potential side effects you’re concerned could come with extended use of Tretinoin?

Expand full comment
author

Hi there, sorry, it may have been worded confusingly: my concern actually wasn't with tret side effects—it was hydroquinone, which you need to build in breaks for otherwise you could get that bluish discoloration with improper use. I'm not aware of any issues with extended tret use. In fact, there are people who've been using it for acne for years then transition into using it for wrinkles, lines, etc, and they see good results.

Expand full comment

This is the best advice on dark spots that I've come across ♡ I'll start with tret

Expand full comment