All You Need To Know About Pigmentation

The term pigmentation refers to coloring. 

It is a pigment called melanin that gives your skin its color. Melanin is made by special cells in your skin. Melanin production is affected by pigmentation disorders. Some pigmentation disorders affect just patches of skin while others affect your entire body.

Melanin makes your skin darker if it produces too much of it. Your skin can become darker during pregnancy, if you have Addison's disease, or if you are exposed to the sun. In the absence of melanin, your skin becomes lighter. 

In most cases, melanin is evenly distributed in the skin, but sometimes people have spots or patches where more melanin is present. For example freckles, age spots (lentigines), and melasma.

Pigmentation Disorders

There are many types of pigment disorders, ranging from widespread disease that affects many areas of the skin to localized complaints affecting just a few. These changes in pigmentation are called:

• Depigmentation
• Hypopigmentation
• Hyperpigmentation

Depigmentation

The term depigmentation refers to the loss of all pigment in the body. The skin is entirely white. Vitiligo causes widespread depigmentation.

Hypopigmentation

Melanin levels are abnormally low in people with hypopigmentation. There is a lightening of the color of the skin relative to its normal color. Albinism is a genetic disease that is characterised by widespread hypopigmentation of the skin. There are a number of reasons why hypopigmentation occurs:

• Skin injuries, such as blisters, ulcers, burns, exposure to chemicals, or skin infections
• An inflammatory condition of the skin, such as such as atopic dermatitis or psoriasis, that has healed over time
• Rare hereditary conditions

Hyperpigmentation

There are several reasons for hyperpigmentation, including excess melanin and pigmented substances that aren't normally present in the skin. There is a noticeable darkening of the skin and sometimes it is a different color than normal. There are several factors that can contribute to hyperpigmentation:

• Skin disorders
• Drugs
• Excessive exposure to sunlight

Types of Hyperpigmentation 

Skin of color is prone to hyperpigmentation due to the presence of more melanin than lighter skin tones. It is possible to develop dark spots on the skin following injuries such as burns, bruises, acne, rashes, or other trauma to the skin. Over 80 percent of women, at some point in their lives, will suffer from hyperpigmentation in some form.

Hyperpigmentation can take many forms, but I will cover a few of the most common types I have seen and treated over the years. Melasma, age spots, and post-inflammatory hyperpigmentation are the most common types of hyperpigmentation. Let us take a look at different types of the condition and effective treatments for hyperpigmentation.

Melasma

Melasma or chloasma is pigmentation found deeper in the dermis of the skin. There is a non distinct border around larger brown patches on the face. Women are more prone to melasma. Hormonal changes may trigger it, though the exact cause is unknown. Pregnancy, some medications, UV exposure, and stress can exacerbate the condition.

Are There Effective Treatments for Melasma?

Occasionally, melasma will disappear by itself, especially if the condition is triggered by pregnancy or medication. Melasma can fade after delivery or when you stop taking medication.

It is also possible for melanomas to persist for years or even a lifetime. Although the presence of melasma does not cause any harm to your body, it's understandable that many people feel the need to treat it.

Treatments for Melasma

Hydroquinone

It is commonly used to treat melasma. When applied to the skin, it evens out the skin tone. You cannot buy hydroquinone without a prescription anymore.

Tranexamic Acid

Tranexamic acid may be applied directly yo your skin or taken as a pill. Studies have shown that tranexamic acid reduces patches of melasma when other treatments have failed.

Q-switched Nd:YAG Laser

Melasma is a very common hyperpigmentation disorder that is often relapsing and therapeutically challenging. Melasma is widely treated with the low-fluence, multipass laser technique called laser rejuvenation, via a Q-switched laser. It is shown to be an effective method to treat melasma without serious side effects in Asian patients.

Pro Yellow Laser

German-made QuadroStar Pro Yellow Laser is CE and FDA-approved. A laser such as the Pro Yellow is very versatile. There are a number of conditions that can be treated with it, including melasma, pigmentation, facial flushing, spider veins, redness after acne, and skin brightening and rejuvenation.

As a result of its unique wavelength, the Pro Yellow laser penetrates the melasma pigments and the blood vessels that surround them simultaneously to reduce the blood supply to skin cells which are responsible for melanin production. Hence, it greatly reduces the chance for these cells to produce  pigments to ensure effectiveness in treating melasma.

Freckles

Ephelides, or freckles, are the most common pigmentation type. Those with a fair complexion are more likely to develop them after repeated exposure to sunlight. 

Treatments for Freckles
Topical Medication

Topical treatments are critical to help fade brown discolouration and prevent new areas from appearing. We use established and well studied ingredients in our skincare products, such as retinoids and retinol, hydroquinones, cystamine and Crystal Tomato for the treatment of freckles

Fractional CO2 Laser

Skin irregularities such as acne scarring, deep wrinkles, and other skin irregularities can be reduced by fractional CO2 laser therapy. In this non-invasive procedure, the outer layers of damaged skin are removed using lasers made from carbon dioxide.

Fractional CO2 laser has been widely used since the 1990s and has shown to be an effective treatment for freckles.  

Post-Inflammatory Hyperpigmentation

Acne, burns, friction, and aggressive clinical treatments like chemical peels, dermabrasion, lasers, and IPL can result in post-inflammatory hyperpigmentation. Though it can recur, this condition usually resolves with time and responds to topical products.

Treatments for Post-inflammatory hyperpigmentation
Topical Medication

By accelerating the skin's natural exfoliation process, removing dead skin cells and promoting cell turnover, skincare with glycolic acid, azelaic acid, salicylic acid, kojic acid, vitamin C, niacinamide, and retinoids can reduce the appearance of PIH.

Solar Lentigines

They are pigmented spots with clearly defined edges known as liver spots or sun spots. Their color ranges from light brown to black and can appear anywhere on the body. Melanin pigments are affected by UV light exposure, and how much UV light is absorbed by them determines the severity of these spots. There is a risk of skin cancer and melanoma developing from these lesions. It is essential to consult with your doctor on an annual basis.

Treatments for Solar Lentigines
Topical Medication

A range of topical therapies are currently available for the treatment of solar lentigines. The principal mode of treatment is the disruption of melanin production. Hydroquinone and retinoic acid are widely for the treatment of Solar Lentigines

As with all treatments, it is important to consult a clinic with experienced practitioners who are able to accurately diagnose the type of pigmentation in order to prescribe an effective course of treatments for hyperpigmentation.

Need more advise on your skin pigmentation?  Contact us today and book a consultation with one of our doctors.