How To Get Clear, Even Skin

The Truth About Tone

When it comes to skin ageing, crow's-feet and wrinkles get a lot of attention. We're shocked to see our first lines, but barely notice uneven pigmentation. But, according to Dr Neal Hamilton of Concept Cosmetic Medicine, Sydney, uneven tone – which can include freckles, premature age spots and general dullness – is one of the first signs of skin ageing. This is particularly prevalent in Australia, thanks to our harsh climate and love of the outdoors. Associate Professor Greg Goodman of the Dermatology Institute of Victoria cites recent research, which shows an even skin tone is very strongly linked with how somebody's health, attractiveness and age is perceived. "In a most interesting study, an image of a patient was digitally manipulated and onlookers were asked to guess their age," he explains. "The first manipulation was to remove the wrinkles, but this only made a visible difference of one year in the perceived age. When the colour was evened out, it made a difference of five years, and when both the wrinkles were removed and the colour was evened out, a difference of 15 years was noted."

The Causes

"Every type of skin is prone to pigment spots – they can develop in all ethnicities," reveals Dr Raymond Boissy of the University of Cincinnati College of Medicine in the US. Pigmentation occurs because the body either produces too much or too little melanin, the natural pigment that colours our skin. Here are some of the factors that can trigger an uneven complexion...
Long-term sun exposure: "One of the major stimulators of pigmentation is sunlight. When outdoors, the skin produces melanin [our body's natural sunscreen] to protect itself from UV light," explains Dr Boissy. Over time, accumulative sun exposure can cause damage to the pigment cells, leading to sunspots.
Hormones: "Uneven skin pigmentation in younger people is most often hormonal and is called melasma or chloasma," says Dr Goodman. "This is a mixture of female hormones and sunshine acting in tandem, and can be severe during pregnancy and in those on the oral contraceptive pill."
Acne and scars: When a blemish or abrasion starts to heal, your skin produces melanin to help protect the delicate area. According to Dr Boissy, sometimes this defence mechanism doesn't switch off once the wound has healed, leading to a lasting brown mark.
Medication: Some prescription drugs can also lead to increased skin sensitivity to sunlight. Common medications include the pill and acne treatments, and your doctor should warn you of the side effects.

Treatment Options

1. Daily care
Best for: Reversing the earliest signs of ageing by giving your complexion a brightening boost every day.
Why: Adopt a radiance-enhancing skincare routine for a clearer complexion. "Results should be seen within the first few months, but there's no reason why this sort of regimen shouldn't be long-term," says Dr Goodman.
How: Speed up skin cell turnover and facilitate the removal of surface pigment by using a gentle resurfacing cleanser, such as Innoxa Renew Triple Action Gel Wash, $17.95. Then, scrub twice a week with Clarins White Plus Gentle Brightening Exfoliator, $70, or, for a gentle exfoliating alternative, use Shu Uemura Whitefficient Intense Whitening Essence, $115, after washing your face each day. Next, apply a serum and moisturiser that contain active brightening ingredients, such as niacinamide and vitamin C, to help even out your complexion. We like Jan Marini Skin Research Age Intervention Enlighten Facial Lotion, $160, and Jurlique Purely White Skin Brightening Night Treatment with Vitabright KX, $70. Finally, always apply sunblock before heading outdoors. "A broad-spectrum sunscreen is imperative in preventing the development of pigmentation," advises Dr Goodman. This is very important when using brightening or resurfacing products. Try Neutrogena Healthy Defence Daily Moisturiser SPF 30+, $17.95, or look for a two-in-one skin-brightening moisturiser with sunscreen, such as Dermalogica Pure Light SPF 30, $124.

2. Targeted Spot Removal
Best for: Zoning in on stubborn or prominent pigmentation spots.
Why: According to Dr Boissy, the latest scientific research into pigmentation shows that for every dark spot you can see on your face, there are five times as many developing underneath. He insists that the secret to achieving and maintaining a clearer complexion, now and in future years, is to work on eliminating the development of these pigment spots before they can move to the surface of your skin.
How: Step up your daily skincare routine by applying a concentrated product, such as SK-II Whitening Spots Specialist, $175, which not only treats the visible spots but also those that are making their way towards the surface of your skin. Dr Goodman also suggests investing in a serum that contains ingredients like niacinamide, azelaic acid, licorice extract or low concentrations of hydroquinone and kojic acid. "These are all relatively potent in either stopping the production of pigment or its transfer [to the exterior of your skin]," he says. Try Lancôme Blanc Expert Melanolyser Whiteness Activating Spot Eraser, $118, and SkinCeuticals Pigment Regulator, $149, which both claim to break up surface pigmentation, while working to inhibit melanin production as well. You'll need diligence and patience, though, as it may take a few months of regular application to see results.

3. Intensive Exfoliation
Best for: Reversing dullness and removing built-up layers of sun-damaged skin.
Why: "Exfoliation is good for a multitude of reasons," claims Dr Boissy, who explains it speeds up cell turnover in mature complexions, while preventing the build-up of melanin by removing it early without damaging the skin.
How: Avoid scrubs that contain crushed nuts and seeds, as these can be overly abrasive. Instead, look for options that contain alpha and beta hydroxy acids (AHAs and BHAs), as these will gently deal with dead cells without weakening skin. To help tackle sun damage, replace your regular cleanser with Dermalogica Tri-Active Cleanse, $80. It contains lactic acid to help remove old cells, plus trusted skin brighteners, like niacinamide and vitamin C, to further help break down pigmentation. Next, choose a treatment lotion, such as SkinCeuticals Retexturing Activator Serum, $110.65, and apply each day to help speed up cell turnover. Alternatively, get faster results at home with intensive weekly peels. We like the Clinique Turnaround Radiance Peel and Calming Cream System, $110.

Professional Help
Best for: Treating uneven skin tone from years spent in the sun, or to remove stubborn pigmentation patches.
Why: While Botox is often credited as the anti-ageing secret of celebrities, this much-hyped product only treats wrinkles, and not the skin's tone and texture. Lasers and light therapy are the real powerhouses behind the crystal-clear complexions on the red carpet.
How: According to Dr Hamilton, you have two options: laser resurfacing, or non-resurfacing treatments, such as intense pulsed light (IPL) and light therapies like Omnilux. "In general, a laser will outperform IPL, but for mild to moderate problems, IPL provides a very adequate alternative," he explains. "If skin quality is the issue, laser resurfacing is the most superior treatment. It requires three to 10 days of downtime and a budget of $1200 to $5500 depending on severity [of skin damage]." Non-resurfacing options have no downtime and are less painful and costly (expect to pay between $200 and $1000). Do seek advice from a trusted medical practitioner, though, as laser technicians are not regulated across Australia.

Instant Radiance Boosters
Get an ethereal glow with products that contain very fine, illuminating particles, which will help to create the appearance of a more even skin tone. Best buys: Biotherm Flash Recharge Ginseng Glucose Radiance Concentrate, $65; Rodial Glamtox Eye Light Pen Eye Brightening Concealer, $60; Clinique Even Better Makeup SPF 15 in Cream Chamois, $49; Chanel Base Lumière, $72; Bobbi Brown Luminous Moisturizing Foundation in Warm Beige, $80; NARS Illuminator in Copacabana and Orgasm, $69 each; Issada Mineral Baked Velvet in Opal, $69.