Episode 25: Pigmentation Problems — Treating Dark Spots, Melasma & PIH

Episode 25: Pigmentation Problems — Treating Dark Spots, Melasma & PIH

From stubborn acne marks to melasma and sunspots, unwanted pigmentation is one of the most common reasons people see a dermatologist. In this episode, Dr. Dustin Portela and PA Austin Lee break down the different types of pigmentation, why they happen, and the science behind how to treat them.

They cover post-inflammatory hyperpigmentation (PIH), melasma, sunspots, freckles, and even lighter pigment changes like idiopathic guttate hypomelanosis. You'll learn why pigmentation is so persistent, how heat and even blue light can make melasma worse, and why sunscreen is always step one. Dustin and Austin also dive into prescription options like hydroquinone, over-the-counter ingredients like kojic acid and niacinamide, and emerging alternatives like thiamidol and melasyl. They also explore in-office options—chemical peels, lasers, and microneedling—and explain which treatments work best for which conditions.

This week's "Did You Know?" reveals just how common pigmentation really is in dermatology offices—and why it often shows up alongside other concerns.

Follow Us:
Dr. Portela
TikTok: @drdustinportela
Instagram: @drdustinportela
YouTube (Reactions): @208SkinDoc
YouTube (Educational): @drdustinportela
Pinterest: @DrDustinPortela

Austin Lee
TikTok: @austinleepac
Instagram: @austinleepac

Product of the Week — Eucerin Radiant Tone Collection
Featuring thiamidol, a unique ingredient that helps reduce pigmentation without the risks associated with hydroquinone. The line includes a gentle cleanser, serum, tinted SPF, and night

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EP 53: Derm Myth Court: Tanning for Vitamin D? Oily Skin Doesn't Need Moisturizer? — Part 2

EP 53: Derm Myth Court: Tanning for Vitamin D? Oily Skin Doesn't Need Moisturizer? — Part 2

Some skincare myths are easy to knock down. The ones in this episode are trickier, because the prosecution actually has a case. Round two of Derm Myth Court brings three myths that feel more defensibl...

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EP 52: Derm Myth Court: Does Sunscreen Cause Cancer? Beef Tallow? Lemon Juice for Acne? — Part 1

EP 52: Derm Myth Court: Does Sunscreen Cause Cancer? Beef Tallow? Lemon Juice for Acne? — Part 1

Some skincare myths are easy to dismiss. Others are built on just enough real science to sound credible, and those are the ones that spread. For the first episode of Derm Myth Court, Dr. Dustin Portel...

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Featured Episode: A Medicare Proposal Could Change How You Receive Care — Here's What You Can Do

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12 Aug 18min

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At 40, Dr. Mary Alice Mina noticed her neck for the first time. She was a dermatologist, she knew the science, and it still caught her off guard. That moment of recognition is exactly what she now bui...

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EP 51: Sunburn, Sweat Acne and Summer Skin Damage — What Dermatologists See Every July

EP 51: Sunburn, Sweat Acne and Summer Skin Damage — What Dermatologists See Every July

Summer has a way of reminding people that their skin has limits. Every July, the same things land in Dr. Dustin Portela and Austin Lee's clinic: sunburns that crossed a line, back acne that appeared o...

30 Juli 38min

EP 50: When Your Skin Is Trying to Tell You Something Is Wrong Inside

EP 50: When Your Skin Is Trying to Tell You Something Is Wrong Inside

Your skin is not just your largest organ. It is also, occasionally, a window into something going wrong much deeper than the surface. Autoimmune disease has a reputation for being mysterious, slow to ...

23 Juli 42min

Guest Episode: Johanna Young of Solbari on Sun Protective Clothing, Skin Cancer Prevention, and What Australia Gets Right

Guest Episode: Johanna Young of Solbari on Sun Protective Clothing, Skin Cancer Prevention, and What Australia Gets Right

Two in three Australians will be diagnosed with skin cancer by the age of 70. That statistic is the backdrop for everything Johanna Young does. Johanna is the founder of Solbari, an Australian sun pr...

16 Juli 30min

Featured Episode: Dr. Portela on Derm It Trotter, Debunking Social Media Skincare Myths

Featured Episode: Dr. Portela on Derm It Trotter, Debunking Social Media Skincare Myths

Not everything trending on your feed deserves a place in your routine. This week, we're sharing a conversation Dr. Portela had on the Derm It Trotter podcast, hosted by board-certified dermatologist D...

9 Juli 32min

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