Further information about pigmentation...
Abnormal Pigmentation of the skin can be one of the most difficult skincare problems to solve. There are many different forms of abnormal pigmentation, from freckles and sun spots to melasma and post inflammatory ( post skin injury ) hyperpigmentation. Abnormal pigmentation is also one of the commonest skincare issues and can affect people of all skin types and colours.
Why does abnormal pigmentation happen?
Abnormal pigmentation is caused by abnormal behavior of melanocytes.
The melanocytes are pigment producing cells which lie in the base layer of the epidermis. Melanocytes contain melanin and the amount of melanin determines our genetic skin colour. The role of the melanocytes is to protect other skin cells from mutation from the UV radiation the skin receives during sun exposure. Understanding this role is the key to understanding why abnormal pigmentation occurs and how we can prevent and treat this skin condition.
Melanocytes have long arms that stretch up into the upper layers of the epidermis, allowing them to make contact with many skin cells. When the skin is exposed to UV radiation, the melanin granules contained in structures called melanosomes, migrate from the melanocytes into the surrounding skin cells. This is called a tan. The melanosomes coat the nuclei of the skin cells, protecting them from UV radiation and the risk of mutation. As these skin cells are pushed upwards to the surface of the skin, they exfoliate and the skin returns to its natural colour.
The number of melanocytes each skin has, is the result of thousands of years of evolution. The skin has evolved to have the right number of melanocytes to protect the skin from the UV radiation risk associated with the geographic region the skin inhabits. If a skin type, with a melanocyte count evolved for one region, is then relocated to a region with a much higher UV exposure, the inbuilt melanin skin cell protective system can be very easily overwhelmed.
The first sign that this melanin protective system (MPS) has been overwhelmed is the vertical clumping of melanin. We call this a freckle. Over time as the skin receives continued UV overexposure, melanin starts to horizontally clump, producing a melasma (dermal pigment staining) type hyperpigmentation, which, unlike hormone induced melasma, is very difficult to treat.
Following years of overexposure to UV, the melanocytes can be completely overwhelmed and die, leaving small round patches of de pigmented skin. This is evident on the forearms of most Caucasian Australians, over the age of 40.
Melanocytes can also overproduce melanin in response to hormones, skin injury, inflammation and some drugs. The most common reason for hyperpigmentation in the skin is UV overexposure and the second, scarring, in particular, acne scarring. Some skins are more prone to hyperpigmenting than others and one theory postulates this may be due to genetic mixing of different skin types eg Caucasian/Asian: African/Hispanic: Asian/Hispanic.
Firstly, there are no quick fixes for abnormal pigmentation. Some pigmentation will clear fairly easily but other pigmentation can be really really treatment resistant and it is impossible to predict which pigmentation will or will not respond. Generally, hormone induced and post inflammatory hyperpigmentation are the most treatment responsive whereas sun induced melasma can be the most difficult to treat. You need time, patience, and the daily use of skin care products in order to get rid of hyperpigmentation. If you have had a dark spot on your face for 6 years you cannot expect it to disappear in just a month. When I say patience I really mean it. You need to use the right skin care products at home in order to eventually see results months down the road. Once hyperpigmentation occurs, it can easily recur, even after it has been successfully faded. If anyone promises you a miracle cure for hyperpigmentation run in the opposite direction. Also please don’t put lemon juice all over your face and go out in the sun expecting to fade dark spots.
One of the most effective skincare ingredients used to treat hyperpigmentation is hydroquinone. Hydroquinone is controversial for a few different reasons but it still remains one of the most effective ingredients for fading abnormal pigmentation.
Other skincare ingredients that can help treat hyperpigmentation are: Vitamin C, Kojic acid, and Azelaic acid. A product with one or more of these ingredients is best paired with a retinol (or prescription Stieva-A) for best results. We recommend using a combination of hydroquinone and kojic acid ( Lighten ) daily and twice weekly Azelaic Masks.
For really stubborn or treatment resistant abnormal pigmentation, you can use our Melasma Peel every 4 to 6 weeks.
And above all, apply a generous amount of sunscreen each and everyday! Use at least SPF 30 and make sure your sunscreen protects from both UVA and UVB rays.