Love hot yoga and love healthy skin? Keep reading!

Hot yoga  — so many people love it and don’t want to live without it! Did you know that hot yoga has been on the scene since the early 70s, but has been evolving on the regular? Over the years, heated studios have experimented with everything from room temperature (which ranges from around 90 to 108 or even higher) and appropriate poses to sweat-friendly gear and, most recently, their heat sources.

This latest hot yoga trend has some studios swapping out conventional forced-air systems for infrared (IR) heating ones. You’ll hear claims of all sorts of health benefits including increased metabolism and weight loss, improved flexibility, greater detoxification, and even reduced fine lines and wrinkles. People taking these hot yoga classes seem to love IR heat because it feels less heavy and oppressive than conventional heating methods and more like baking in the sun on a warm (okay, really warm) day.

This sun-like warmth makes perfect sense when you consider what infrared light is. It’s actually invisible, but IR light is felt as heat and is able to penetrate skin and heat even the deepest layers. In fact, about half of the sun’s energy is in the form of infrared. Which begs the question: Are we sure all this internal skin “baking” is safe/healthy?

“It really comes down to how controlled the ‘dose’ of IR energy is,” says Dr. Whitney Bowe, dermatologist and author of the new book The Beauty of Dirty Skin. “IR light-based therapies have been used clinically to promote wound healing, protect muscles from stress, and reduce inflammation. In fact, I use some IR devices in my office and recommend some at-home devices to my patients that are based on IR energy. But many people don’t realize that prolonged infrared exposure has detrimental effects on the skin.”

For starters, uncontrolled doses of infrared rays have been shown to damage skin by creating oxidative stress and free radicals, according to a research review in the journal Photodermatology, Photoimmunology & Photomedicine. Free radicals are highly reactive forms of oxygen that can damage cell membranes, DNA, and structural proteins like collagen and lead to premature aging, chronic skin conditions like acne, and even skin cancer.

“Extended exposure to IR energy has also been shown to alter the function of skin’s mitochondria, the powerhouses of cells, and stimulate the activity of enzymes called MMPs that degrade collagen,” says Dr. Bowe. “And high levels of IR heat can theoretically challenge the skin of anyone with a chronic condition that’s characterized by pigmentation, such as melasma and post inflammatory hyperpigmentation.”

At this point you’re probably thinking it’s time to turn in your IR hot yoga towel, but Dr. Bowe says it’s not necessary to give it up altogether unless you suffer from melasma. “I urge my patients to pause their passion for hot yoga. I’ve seen one hot yoga class take us back 6 chemical peels and 4 months of potent prescription peels,” says Dr. Bowe. Her advice: if you are going to keep up with a hot yoga routine, prioritize protecting your skin before you head in to the studio. And in fact, you should take precautions anyway: you’re getting hit with IR every day from other sources as well, namely the sun – and traditional sunscreens don’t protect against IR rays.

“I’m a firm believer in protecting the skin from uncontrolled IR rays using an outside-in and inside-out approach,” Dr. Bowe says. Here are the six smart skin strategies she recommends employing every day, even when you’re not rolling out your mat.

Apply a topical vitamin C serum.

Vitamin C is a potent antioxidant that stimulates collagen production and combats free radical damage from IR rays and – get this – exercise. “Your body produces free radicals through normal metabolic processes like respiration, so when you work out, you produce more free radicals,” says Dr. Bowe. Choose a lightweight serum that doesn’t clog your pores, and be sure to cover your face, neck, chest, tops of your hands, and any other regularly exposed skin.

Supplement with Heliocare.

This natural supplement contains a patented specialized extract of Polypodium leucotomos (PLE), a tropical fern native to Central and South America that’s been used for centuries as a remedy for various skin conditions. PLE’s powerful antioxidant properties help protect your skin from the inside out from free radicals. Dr. Bowe recommends taking one pill every morning; two if you’re heading out in the sun (but it’s not a substitute for sunscreen).

Sip a collagen smoothie.

Supplementing with collagen can help combat the wrinkling caused by IR heat exposure, says Dr. Bowe. It’s the main structural protein in skin, and its two main amino acids – proline and glycine – are essential for the formation and repair of healthy skin. “I like collagen powders from marine sources,” she says. “Marine collagen is smaller in molecular size than collagen derived from cows or pigs, so it’s more bioavailable and thus more likely to get into your bloodstream and reach the places where it’s meant to work its wonders.”

One of Dr. Bowe’s favorite smoothie recipes: Blend together 1¼ cups unsweetened almond milk; 1 tablespoon each of collagen powder, cacao powder, and almond butter; 1 small banana, frozen in chunks; ½ cup fresh or frozen blueberries; 1 cup loosely packed baby spinach; and 2 ice cubes (if using fresh blueberries).

Eat foods rich in vitamins A and C.

Both nutrients play a key role in boosting your body’s collagen. “Vitamin A helps restore and regenerate damaged collagen, and your body can’t even make collagen without vitamin C,” says Dr. Bowe. Dark leafy greens (such as kale, spinach, and chard) are high in both A and C. Top sources of C include oranges, red bell peppers, Brussels sprouts, strawberries, grapefruit, and guava. Foods high in vitamin A include carrots, squash, mango, and watermelon.

Get extra C.

Vitamin C is easily lost in urine, says Dr. Bowe, so in addition to eating C-rich foods throughout the day, she recommends supplementing with 1,000 milligrams of C daily.

Supplement with vitamin E, too.

Another powerful antioxidant, vitamin E stops the production of free radicals, and researchers are looking at E as a possible preventive measure for skin disorders associated with free radicals. It’s tough to get enough E in your diet – sunflower seeds and some nuts contain small amounts – and UV damage depletes our levels, says Dr. Bowe, so she recommends taking 400 IU a day.

Ultimately, whether you decide to stick with IR yoga or not, we all know we need to keep up our mind-body practices and our skin care regime. It’s a fact that doing yoga offers its own benefits, including reduced inflammation, lower levels of the stress hormone cortisol, and greater numbers of healthy mitochondria – all of which are associated with healthier, younger looking skin.  But when we are truly happy and find time for self-care you sport the Instagram-worthy natural glow. In sum: keep oming and keep glowing.


Dr. Whitney

You guys asked so many insightful questions about this subject, so I am answering a number of them here and then, we will also have another post, Melasma 104, in order to address the broader questions.

This Q & A is intended to empower you with knowledge and information to discuss with your physician. Without seeing each and every one of you in my office as a patient, I cannot provide personal medical advice. Instead, my goal is to share my knowledge and experience in order to serve as a guide for you – arming you with the knowledge you need to help make excellent medical decisions with your personal doctor.

Here goes!

Q: Which peels, lasers, etc would be safe for a patient with Melasma.

Dr. Whitney Bowe: I will address this question from an in-office and an at home perspective.

I offer superficial, medium and deep peels in my office. The depth of the peel plus the combination of ingredients has a major impact on which skin issues the peel addresses as well as how much downtime/recovery is involved post-peel. Many of my patients come into my office recounting the Sex and the City episode where Samantha had that horrendous chemical peel. As I tell my patients, not all peels are created equal, so you really want to be sure that you are in very experienced hands when it comes to these types of peels, particularly if you have Melasma.

Over the years, I’ve found that the best in office “peel recipe” for Melasma is a series of at least 10 monthly superficial peels. Superficial peels don’t penetrate too deeply into the skin, and the cumulative effect of these peels is more effective AND results in fewer side effects than a smaller # of medium or deep peels.

If someone with Melasma also has acne prone skin, or the type of rosacea that leads to swollen looking pores (what I call a peau d’orange, or orange peel appearance to the skin), then I begin with salicylic acid peels. Salicylic acid is incredibly effective at dialing down redness in the skin. It’s very closely related to aspirin on a molecular level, and we know aspirin is an amazing anti-inflammatory. My patients note that salicylic acid peels tend to be very calming and anti-inflammatory. These peels also typically don’t make you more sensitive to the sun, so these are my go-to peels all summer long.

If a patient presents with dry skin, and isn’t struggling with redness, then I might start with a series of glycolic acid peels. There’s a major misconception that the higher the percentage, the stronger the peel. However, it’s not just percentage that matters . . . it’s also the pH of the peel, and whether the peel is buffered or not. So you might go to a spa where an aesthetician is using a 70% glycolic peel on your skin, but that peel is very buffered and hence much weaker than a 30% peel I use in my office!

If you’re thinking about starting a series of peels with your practitioner—a few things to keep in mind and to discuss with your doctor:

  • I recommend that my patients refrain from using anything that could irritate your skin in the days leading up to the peel. I have my patients stop using any products containing retinoids or benzoyl peroxide four nights prior to peels in my office
  • Your skin should be prepped prior to the peel, to ensure it penetrates evenly. This step “degreases” the skin, so it removes any built up oils or sebum on the skin that might affect the peel’s ability to penetrate evenly.
  • My staff uses a barrier ointment to protect the delicate areas on the face where the acid can pool. They paint it on using a Q-tip.
  • Some peels are re activated by exposure to water, so be sure to ask how long to wait before sweating or exercising or washing your face again.

The peels you purchase online or over the counter, that are meant for at home use, tend to be much weaker than in office peels. However, you can still run into trouble. At home peels contain many of the same ingredients as in-office peels, so they do come with a risk of burn or skin irritation if used improperly. One at home salicylic acid peel that has consistently been given rave reviews by my patients is the Exuviance Performance Peel AP25. The ease of use is definitely a key feature of this peel, as you are using pads rather than a dropper. I often recommend that my patients start off trying these once per week to determine their skin sensitivity and to assess whether there is any reaction. Follow with a moisturizer, as these peels can be drying.

Q: What makeup is best to cover melasma? I noticed a lot of makeup brands sit on top and do not help cover.

Dr. Whitney Bowe: My patients with Melasma consistently love a product called Dermablend.

I also regularly recommend the Bobbi brown color corrector. I actually use this to cover up both uneven pigment AND broken blood vessels or red areas. Pat, don’t rub, onto spots that require coverage. Then use your regular foundation all over on top. I use this like a concealer/spot corrector.

And, here are a few makeup tips which I share with my Melasma patients: Always begin by using a moisturizing sunscreen underneath your foundation! Studies show that people use about 1/7th of the powder or foundation they need to get the SPF on the label – meaning, you would need to apply 7 coats of the makeup/powder you would normally use to get the SPF you think you’re getting. This is not true of moisturizing sunscreen/moisturizer with SPF so, I recommend beginning with this type of product, allowing it to absorb, and then applying your makeup on top. If your makeup also includes SPF, this would be icing on the cake.
Never rub your foundation. Instead, pat or blot it on with a sponge or fingertips. Rubbing can actually irritate/inflame your skin, which can make Melasma worse.

Q: I have heard microdermabrasion is helpful. Do you think so or could it make it worse?

Dr. Whitney Bowe: In my experience, Microdermabrasion can make Melasma worse, so I tend to avoid it in my Melasma patients.

Q: What is your recommended skincare routine, including ingredients, for patients with Melasma?

Dr. Whitney Bowe:


I always recommend that my Melasma patients begin with a Heliocare supplement every morning. Heliocare has been studied in patients with Melasma and a recent study ( demonstrated its efficacy when used in combination with sunscreen and hydroquinone.  Subjects who also took Heliocare, along with those other measures, actually had a faster response and accelerated brightening of their dark spots compared to those who took a placebo. Slow response to treatment is one of the most frustrating aspects of Melasma, so anything that is proven to safely speed along the progress is key!

In addition to taking a Heliocare supplement, I recommend that in the morning, my Melasma patients cleanse their skin with a gentle cleanser (ex: LRP) using fingertips only. Pat your skin dry (don’t rub). Next, you can add a couple of drops of your favorite Vitamin C Serum (see those listed below) into your moisturizer with SPF, or you can use a layering approach – apply your antioxidant serum first and then layer your moisturizer with SPF on top of it.  Follow with makeup per my description.

For my sun hat and lifestyle recommendations for patients with Melasma, please check out Melasma 101 and 102.


In the evening, I recommend that my Melasma patients alternate between an antioxidant serum like La Roche-Posay’s CE Ferulic or Dermalogica biolumin c serum and a retinol-containing product like dermalogica’s overnight retinol repair or one prescribed by your doctor.

Also, I usually prescribe a Melasma Emulsion – which my patients often mention on social media — or a BLEND of ingredients to use a few nights a week- talk to your derm about getting one customized to meet your needs. I choose from ingredients like HQ, kojic acid, tretinoin and hydrocortisone. I do not sell this emulsion on my website. This is an in-office customized prescription.

Dr. Whitney

What can I do to address my Melasma? The first thing I tell my patients is that we cannot “cure” this condition. BUT, we can get it under control. You have to be like a tortoise—slow and steady wins the race! Here is a step by step guide that I would discuss with my patient if she presented with Melasma:

1. Sun Exposure

  1. I recommend that my patients wear a broad-rimmed hat when they are outside during the summer months without exception. If someone looking at you can see a criss-cross pattern of sun on your face, that’s not effective enough. Here’s an example of tightly woven hats with built in sun protection:,,
  2. Of course, it goes without question that you have to wear a topical sunscreen and you should be generous with your sunscreen and reapply frequently. Many of my patients swear by mineral/physical blockers, as they find that the chemical blockers (even though they test incredibly effectively), seem to aggravate their Melasma symptoms. Think Sport and Pacifica are two brands which I regularly have in our family’s rotation.
  3. Seeking shade is non-negotiable. No matter how powerful your sunscreen, or how wide your hat, you must seek shade between the hours of 12 and 2. And not just under an umbrella. Studies show most beach umbrellas do NOT provide sufficient protection from UVA and UVB rays. I tell my patients to seek shade under a wood canopy or go indoors. REAL shade.
  4. Light reflects off of the water, so when you are swimming, even if you are wearing a hat, the rays are bouncing off the water and hitting your face. I recommend that my Melasma patients try to swim in the morning or late afternoon when the sun isn’t as strong – or opt to swim in the shady part of the pool.

Heat ExposureIf you feel heat on your face, that can make your Melasma worse. I have patients who are chefs, opening and closing the oven all day, and when they finally take a vacation from work their Melasma clears up simply because they aren’t getting that heat from the oven. Infrared heat can also make Melasma worse— that means infrared saunas and at home devices are NOT good for people prone to Melasma. Time to give up your hot yoga- most hot yoga classes are heated using IR devices. IR can also come from space heaters and certain hair dryers. Rule of thumb: if your face feels hot, chances are your Melasma is about to get worse.


  1. I recommend that my Melasma patients begin taking a Heliocare antioxidant supplement that works as a complement to your sunscreen to increase your protection from the inside out. This is not the type of “sunscreen pill” that the FDA warned about. See my post here about “sunscreen pills” (  Instead, Heliocare is a proven supplement, backed by science, which has shown to be highly effective.
  2. There are also some strains of probiotics that can boost the effect of your sunscreen and protect against UV rays from within. I include this information and examples in my book, The Beauty of Dirty Skin.

Thinking outside the boxUVA rays penetrate through window glass. You can get yours tinted with UV protective tints, or you can reapply your sunscreen every time you take a drive. Today, UV-screening residential and commercial film is available for home and office. UV absorbers are added to clear or tinted polyester or vinyl to create the film, which comes in varied tints, allowing 30-80 percent of visible light to get through. The installers apply it on the interior glass surface of the windows from flat sheets. Window film will help prevent sunburn and skin cancer, as well as the brief daily UV exposures that accelerate skin aging over time. To learn more, check out this link on

I see so many patients who are struggling with Melasma in my office – and so many of you have reached out to me on social media with questions and concerns about this condition. Melasma causes a lot of stress, particularly during summer, because you want to be outdoors in the sun and at the beach or pool, yet you feel the heat on your skin and you know it’s making your Melasma worse. It’s incredibly frustrating and there is so much misinformation out there. Thank you for your questions and I hope that this blog post helps to shed some light on the facts about Melasma.

1. What is melasma?
Melasma is a type of hyperpigmentation which is characterized by dark brown or gray-brown patches of skin on your cheeks, forehead, nose or chin. My patients often describe it as having the appearance of “paint spatter” on their skin.

2. What causes Melasma?
It’s caused by a combo of HEAT plus SUN plus HORMONES (women are much more likely to have Melasma than men, and birth control pills and pregnancy can be a big trigger).

3. Am I making my Melasma worse in trying to treat it?
Oftentimes, I see patients who have been trying all sorts of home remedies which are actually making their Melasma worse. For example, many people want to try to scrub or exfoliate their Melasma away by reaching for powerful ingredients and aggressive tools and overusing them. However, anything that creates redness and irritation can actually set you back. If you use lasers or lights to see results fast- oftentimes, this will exacerbate your Melasma. Even if a procedure or device seems to make the skin look lighter initially—it can sometimes prime or sensitize the melanocytes (your pigment producing cells) and then, the next time you’re in the sun even just for a short time, they pump out pigment even faster than before – it’s as if they’ve been sensitized/primed to be supersensitive to even tiny exposures to the sun.

These are the basics about Melasma. Stay tuned because I will be sharing Melasma 102 very soon, which is all about my suggested game plan to address this condition.

There are so many popular myths about Melasma! I am here to help you get the FACTS you need to keep your Melasma under control.

FIRST, no lemon juice.  If you google “home remedies for Melasma” you will find pages of home remedies listing lemon juice as one of the key ingredients. this is a MYTH!!! Do NOT use lemon juice on your Melasma!  Citrus fruits can irritate the skin, which can make Melasma worse.  AND lemons in particular actually make your skin much more vulnerable to the sun. I’ve seen these remedies make Melasma 10x worse in just 24 hours.

SECOND, no heat! Anything that causes too much heat or irritation in the skin can make Melasma worse! When it comes to Melasma, your doctor has to be gentle and you have to be patient. Trying to rush that process will only set you back. This means:

  • NO Hot yoga
  • NO saunas
  • NO steam rooms
  • NO sunbathing
  • NO tanning salons

THIRD, what should you look for: look for serums, lotions and creams that contain Vitamin C, kojic acid, licorice, or soy. Those are brightening ingredients that have been shown to gently lighten Melasma patches over time.

FOURTH, sun protection!! This is critical to your Melasma treatment!

FIFTH: I wanted to share the regimen that I provided to Ginger to treat her Melasma for your ready reference:


  • cleanse with a gentle cleanser (Purpose, Dove, Cetaphil all good) fingertips only
  • pat dry using a clean towel
  • put a few drops of SkinCeuticals CE Ferulic antioxidant serum into La Roche Posay sunscreen
  • rub all over face and neck.  CE ferulic has Vit C (skin brightener) AND acts as an antioxidant, neutralizing free radicals that are thought to trigger Melasma.


HAT– wear a hat when outside!!!  I’m serious


I mixed a Melasma Emulsion for Ginger. Less is more to start. I recommended that she use it every other night for the dark areas ONLY. Key ingredients here are Hydroquinone (which acts to block the enzyme that makes melanin and is the MOST powerful depigmenting topical ingredient for Melasma) and Tretinoin (prescription strength vit A) which increases skin cell turnover, bringing the stained cells to the surface where they ultimately slough off.

Alternate nights: dr. brandt DNA Night Cream (loaded with antioxidants) or a gentle moisturizer like Cetaphil or CeraVe.

4 nights before each PEEL: STOP the Melasma emulsion.

Check out the segment right here:

Share your thoughts and questions about Melasma with me on social media! My handle is @drwhitneybowe on FB, TW, and IG!


Dr. Whitney


RT @DrWhitneyBowe: Brand new Picks Page post about a supplement that can help reduce your risk of developing skin cancer. In view of the FD…



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