Addressing Common Skin Concerns: AHA, Whitening, and Salicylic Acid Issues

Issues with the use of retinoids, concerns about skin whitening, and problems related to salicylic acid exfoliation?

Hello, Doctor.
Thank you for taking the time to answer health consultation questions.
Having the opportunity to ask these questions is truly helpful for those who are uncertain about how to handle their health issues.
I really appreciate it! I have a few questions I would like to ask you:
1.
Regarding oral retinoids:
1-1.
Can oral retinoids cause photosensitivity? (I have taken oral retinoids at two dermatology clinics, and the pharmacist at the second clinic suddenly mentioned the possibility of photosensitivity, while the first clinic said it wouldn't.
I'm a bit confused.)
1-2.
Can topical retinoids cause photosensitivity?
1-3.
Do all topical acids (such as alpha hydroxy acids, mandelic acid, and azelaic acid) cause photosensitivity?
1-4.
How can one generally avoid issues with photosensitivity and post-inflammatory hyperpigmentation? *I heard that indoor daylight bulbs can also cause hyperpigmentation, so should sunscreen be applied indoors as well?* What SPF should be used to prevent indoor light-induced hyperpigmentation? How often should sunscreen be reapplied? (Since I already have acne-prone skin, I'm worried that being occluded for too long will worsen my acne, and I'm even more concerned about hyperpigmentation.) *If I wear an anti-UV jacket indoors, can it physically prevent hyperpigmentation from indoor daylight bulbs?*
2.
Regarding whitening issues:
2-1.
When choosing a whitening body lotion, I often see online discussions about certain brands causing hair growth.
Is there a medical basis for this correlation?
2-2.
How can I choose a body whitening lotion that won't cause hair growth? Do you have any recommended brands?
2-3.
Do you have any recommended methods for body whitening? Which types of topical products or oral whitening ingredients do you suggest?
2-4.
What are some common photosensitive ingredients found in whitening products? *So far, I have found (not sure about the accuracy) that they include: hydroquinone, arbutin, kojic acid, topical retinoids, and tranexamic acid.* So, as long as a product does not contain these ingredients, it should be fine, right? Are there any other common photosensitive ingredients?
2-5.
For whitening products that contain photosensitive ingredients, is it okay to use them only at night? But won't there still be residues on the skin? Is it advisable to wash these ingredients off in the morning?
3.
Regarding salicylic acid body exfoliation:
3-1.
I have some areas on my body that feel rough, and I'm considering purchasing a salicylic acid body wash.
Do these products work?
3-2.
After using a salicylic acid body wash, will I need to enhance moisturization or take other measures to protect my skin?
3-3.
Will there be photosensitivity issues after using a salicylic acid body wash?
I apologize for the many questions, as I have developed more doubts after researching online.
I hope to receive guidance from a professional doctor.
Thank you, Doctor!

Yuan, 20~29 year old female. Ask Date: 2023/09/09

Dr. Wu Yuxin reply Dermatology

The acids mentioned above all have some degree of photosensitivity, so it is generally recommended to use them at night to avoid exposure to ultraviolet light afterward; typical indoor lighting is usually not a concern.
Arbutin, kojic acid, and tranexamic acid do not have photosensitivity.
As for cleansers, as long as they are thoroughly rinsed off, there should be no issues.

Reply Date: 2023/09/09

More Info

When addressing skin concerns related to the use of AHA (Alpha Hydroxy Acid), whitening agents, and salicylic acid, it's essential to understand the implications of these treatments on skin health, particularly regarding sensitivity and potential side effects.

1. Understanding AHA and A Acid Sensitivity
1-1. Oral A Acid and Photosensitivity:
Oral retinoids, such as isotretinoin, can indeed cause photosensitivity. This means that your skin may become more sensitive to sunlight, increasing the risk of sunburn. It’s crucial to use sunscreen with a high SPF when on these medications and to limit sun exposure.

1-2. Topical A Acid and Photosensitivity:
Topical retinoids, like tretinoin, can also lead to increased sensitivity to sunlight. Users often experience redness, peeling, and irritation, especially when first starting treatment. It’s advisable to apply these products at night and use sunscreen during the day to protect the skin.

1-3. Other Topical Acids and Photosensitivity:
Other acids, such as AHAs (glycolic acid, lactic acid) and BHAs (salicylic acid), can also cause photosensitivity. Therefore, it’s recommended to apply these products in the evening and to use sunscreen during the day.

1-4. Preventing Photosensitivity and Hyperpigmentation:
To avoid issues related to photosensitivity, always apply a broad-spectrum sunscreen with at least SPF 30, even on cloudy days. Reapply every two hours, especially if you are sweating or swimming. Wearing protective clothing and seeking shade can also help. Indoor lighting, such as fluorescent lights, generally does not cause significant photosensitivity, but it’s still wise to be cautious.

2. Whitening Agents and Their Effects
2-1. Hair Growth and Whitening Creams:
There is anecdotal evidence suggesting that certain whitening creams can lead to increased hair growth in some individuals. This is often due to the ingredients that may stimulate hair follicles. However, this is not universally accepted in the medical community.

2-2. Choosing Non-Hair Growth Inducing Products:
When selecting whitening products, look for those that are free from harsh chemicals and known irritants. Ingredients like vitamin C, licorice extract, and niacinamide are often recommended for their brightening effects without the risk of unwanted hair growth.

2-3. Recommended Whitening Methods:
For effective whitening, consider products containing ingredients like hydroquinone, kojic acid, or azelaic acid. These can help reduce hyperpigmentation and even skin tone. However, they should be used under the guidance of a dermatologist.

2-4. Common Photosensitizing Ingredients:
Common ingredients that can cause photosensitivity include hydroquinone, certain essential oils, and some forms of vitamin A. Always check product labels and consult with a dermatologist if unsure.

2-5. Using Photosensitizing Products at Night:
Using photosensitizing agents at night can mitigate the risk of sun exposure, but it’s still essential to cleanse the skin in the morning to remove any residual product. This helps prevent irritation and potential reactions.

3. Salicylic Acid and Body Care
3-1. Effectiveness of Salicylic Acid Body Wash:
Salicylic acid is effective for treating rough skin and acne due to its exfoliating properties. It helps to unclog pores and reduce inflammation, making it a good choice for body washes aimed at improving skin texture.

3-2. Post-Use Moisturization:
After using salicylic acid products, it’s crucial to follow up with a good moisturizer to prevent dryness. Look for non-comedogenic moisturizers that won’t clog pores.

3-3. Photosensitivity with Salicylic Acid:
While salicylic acid is less likely to cause photosensitivity compared to other acids, it’s still wise to use sunscreen when using any exfoliating products, especially if you have sensitive skin.

Conclusion
In summary, while AHA, whitening agents, and salicylic acid can be effective for various skin concerns, they also come with risks of irritation and photosensitivity. It’s essential to use these products carefully, follow up with appropriate skincare, and consult with a dermatologist for personalized advice. Always prioritize sun protection to maintain healthy skin and prevent adverse reactions.

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