Ever feel like your skincare routine requires a degree in chemistry? Between dodging the latest social media hacks, wondering if your phone or laptop screen is secretly giving you dark spots, and trying not to burn your face off with acid serums, caring for melanin-rich skin can feel like a gamble. Also read | Glass skin, slugging or skin cycling: Which skincare trends actually work for Indian skin?
A basic routine usually includes gentle cleansing, moisturisation, and sunscreen, with treatment actives introduced according to the person’s concerns. To clear up the chaos, HT Health Talk — a reader-centric series by HT Lifestyle that gets doctors and healthy experts to answer your actual, everyday questions — tapped Dr Aparna Santhanam, consultant dermatologist at P D Hinduja Hospital & Medical Research Centre, Mahim, Mumbai. Ahead, she is breaking down what actually works for brown skin — and what you should officially stop worrying about: There isn’t one laser or peel that is universally ‘best’ for Indian skin. It depends completely on what we are treating: acne, acne marks, melasma, pigmentation, scars or ageing. For someone prone to pigmentation, I generally prefer treatments that stimulate the skin or work with epigenetics rather than those that cause excessive inflammation. For pigmentation, topical treatment and photoprotection remain the foundation, with procedures used selectively. Certain Nd:YAG and fractional laser approaches can be useful in appropriately selected patients, but they have to be used very carefully. Similarly, superficial peels can be effective, while aggressive medium or deep peels carry a higher risk of pigmentary complications. Pigmentation is a complex condition and not just a problem of excess melanin at a static point. It is often an ongoing process. If there is continued sun or visible light exposure, hormonal influence, acne, inflammation or irritation, new pigment can continue to form while you are treating the old pigment. There is also a point where a single ingredient may simply not be enough. I tell patients that pigmentation treatment is a marathon, not a quick fix. Sometimes we need to change the active, combine treatments or address the underlying trigger rather than continuously increasing the strength of the same serum. With Indian skin, I strongly believe that more is not necessarily more. Irritation itself can trigger pigmentation, so I prefer a simple, structured routine rather than layering five or six actives together. Start one active at a time , give the skin time to adjust, and don’t introduce multiple new products simultaneously. If the skin starts burning, stinging, peeling or becoming persistently red, that’s a signal to step back. The goal is controlled treatment, not constantly keeping the skin irritated. Active rotation also works, but all these treatments, including home care, are best pursued under a dermatologist’s watchful eye. There isn’t good evidence that a particular Indian food or a spicy diet directly causes facial pigmentation. I would be much more concerned about sun exposure, heat, inflammation and hormonal factors. Interestingly, an Indian study found an association between prolonged cooking or occupational heat exposure and the severity of melasma. So heat may matter for people who are already prone to melasma. Daily habits also matter: inadequate sun protection, spending long hours outdoors, and repeatedly irritating the skin can all work against treatment. Adding foods rich in antioxidants, like red and orange foods, may actually benefit from sun protection. I would actually put screen protection last on that list. First, identify and control the cause of the pigmentation. If you have active acne, treat it, as each new inflammatory lesion can create another dark mark. Second, establish good daily photoprotection. Once the skin is stable, treatments such as peels, microneedling or lasers can be considered depending on the diagnosis. Particularly for Indian skin, the treatment itself should not cause further inflammation or pigmentation. The basic principle is to diagnose first, control inflammation, protect the skin, and then treat residual pigmentation. What we do daily in our lives supports us longer than just immediately jumping to treatments. Also, only do treatments under the supervision of certified dermatologists. Botulinum toxin has been shown to be generally well tolerated in people of colour, and we have been using it with great success for youth benefits for over two decades. However, any injection creates a small amount of trauma, and darker skin can be more prone to post-inflammatory pigmentation after inflammation or injury, in those already so inclined. So technique matters: appropriate needle size, gentle injection technique, good asepsis and avoiding unnecessary trauma are important. I would also distinguish pigmentation from scarring. A tiny injection mark is not the same thing as a scar. With a properly performed Botox treatment by certified experts, significant scarring or pigmentation is uncommon and highly unlikely. Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
I would therefore focus less on unnecessarily restricting food and more on controlling the environmental and inflammatory triggers we actually know about. Because pigmentation is visible, i don’t believe in jumping straight to a procedure just. Because someone has brown skin, botox itself does not have a special tendency to cause dark spots simply.
Usually, the serum hasn’t necessarily “stopped working”.
