Summer may feel like a distant memory but the damage can stare you in the face everyday as pigmentation and its appearance is one of the leading signs of ageing.
What is skin pigmentation? Pigmentation issues are caused when the melanin production of your skin changes. The darkness or lightness of the skin depends on the amount of melanin produced by the skin cells and when skin cells are damaged they can make too much or too little melanin causing uneven appearance of the skin. Dark spots are caused by overproduction of melanin while lighter spots are caused when less melanin is produced compared to the surrounding skin.
UV damage is the number one cause of sun spots although there are other conditions like melasma or diseases like Addisons disease that can cause skin pigmentation issues as well. Sun spots are sometimes called Solar Lentigo and are caused by overexposure to the sun without adequate sun protection. Melasma is hyperpigmentation found on the face and can be caused by pregnancy, OCP and sun exposure. Conversely, when very little melanin is created, light patches appear.
Hyperpigmentation can be superficial or it can be deep. Superficial pigmentation is easier to treat with an array of different treatments, both at home and in the office. If pigmentation is deeper, it is more difficult to treat because the cell creating pigmentation is damaged.
What can we do? The good news is that there are treatments that you can do to help improve and sometimes eliminate their appearance. First, PREVENTION is the key!!! Daily use of SPF 30 is essential in your fight against pigmentation, sun damage and preventing skin cancers. I prefer sunscreens containing zinc oxide and titanium oxides because they are chemical barriers against sun damage. Rain or shine, never forget your sunscreen!
home treatments: Any products with retinols, licorice root extract and ascorbic acid (Vitamin C) will help lighten and brighten the skin but do not expect immediate gratification. This takes time and dedication.
office treatments: Depending on the depth and darkness of the pigmentation various lasers such as Pixel and light based treatments like IPL can work. Particular lesions can be frozen off and treatment with medium strength peels can also help eliminate superficial and deeper pigmentation.
Unfortunately after certain skin traumas, such as after aggressive laser treatments or acne, the skins natural response to the inflammation is to produce more pigmentation.
home treatment: Again any treatment mentioned above can help this pigmentation but sometimes prescribed topical creams containing hydroquinone, tretinoin, kojic acids and azelaic acids can help. Prescription creams help shed pigmented cells but will take weeks and often months to see the results.
office treatments: Procedures targeting pigmentation can help as well such as microdermabrasion, pixel and some peels can help.
Melasma: My personal issue, melasma is caused by hormonal changes during pregnancy or while on OCP that can appear on the forehead, cheeks, and or upper lip. It can be worsened with sun exposure and is most common in slightly darker skin types.
home treatments: Again prescription strength tretinoins and hydroquinone can help lighten this pigmentation over the course of months.
office treatment: Microdermabrasion is useful for superficial pigmentation and can be used in combination with topical prescription creams. I do not recommend laser or IPL treatments for melasma patients. While they can temporarily improve the appearance of the melasma, it can often return, sometimes even worse as post inflammatory hyperpigmentation.
Pigmentation gives the skin a more aged appearance, particularly when it is uneven. Lines and wrinkles are no longer the focus on anti-ageing. A clear, bright complexion is the mark of youthful skin. Prevention is the first goal and treatment is the second. When home and office treatments are in use, new generation creams can be used to conceal uneven skin tone. For those with significant discoloration, I personally like Vichy dermablend to help cameoflage the pigmentation. It is an ongoing battle, but educating yourself on prevention and knowing how to properly treat them is the next step.