Hyperpigmentation and Melasma Treatment
“ Most hyperpigmentation can be avoided by sensible sun exposure. Once the dark spots on your face become ingrained you will require laser treatment or prescription medication to correct it. ”
Symptoms and Causes
Before commencing any skin pigmentation treatment it is important that you understand the type of skin pigmentation disorder you have and what is causing your skin discoloration or dark spots on your face to occur.
Skin pigmentation disorders affect the color of your skin. Your skin gets its color from a pigment called melanin, designed to protect your skin from photo damage, which is produced by the melanocyte cells located in your skin’s epidermis. When these cells become damaged or unhealthy, melanin production becomes abnormal resulting in white spots or dark spots on your skin that can affect just patches of skin or your entire body.
(Results may vary with each individual and are not guaranteed)
If your body produces too little melanin, your skin gets lighter (hypopigmentation). Vitiligo, infections, blisters and burns can cause lighter skin.
If your body produces too much melanin, your skin gets darker (hyperpigmentation) especially the forehead, cheeks, upper lip, nose, and chin. Acne, pregnancy, Addison’s disease, intrinsic aging, and sun exposure can all make your skin darker.
Melasma is thought to be caused by genetics, medications, pregnancy, thyroid abnormalities, stress, and/or sun exposure, each of which can create a hormonal imbalance and increase melanin production. The hyperpigmentation from the resulting increased melanin production manifests itself as dark skin patches on the upper cheek, nose, upper lip, and forehead. Sun exposure is a prime trigger for recurrences and this is why people with melasma get it over and over again. Skin types ranging from olive to brown are more susceptible to melasma as your skin has more active melanin producing cells. Melasma, while a form of hyperpigmentation, is best considered a special category of hyperpigmentation due to its connection with hormonal imbalances and the use of treatment protocols which differ from regular hyperpigmentation treatment protocols.
Melasma is challenging to treat if the underlying melasma trigger is not first addressed and resolved. Otherwise, the melasma may clear only to reappear sometime after. A healthy dose of patience is required when treating melasma as it can take months for melasma to clear. Sun protection is a must for melasma sufferers and physical sun screens (non-chemical sunscreens) are preferred as they do a better job of providing broad spectrum UVA/UVB protection for all skin types.
Some of the more commonly treated types of hyperpigmentation are discussed below. Apart from freckles, most people should expect that at some time they will have to deal with one or more of these hyperpigmentation issues.
Sun spots are flat, non-connected brown spots on your face, décolletage, arms and back of hands caused by years of over stimulation of melanin from sun exposure. The damage occurs over time and while it may be less visible in your earlier years can become more visible in your later years as the cumulative effect of the sun damage eventually shows. (Referred to as solar lentigo; pl: solar lentigines).
Age spots are not caused by over stimulation of melanin from sun exposure, but are yellowish/brown oxidized lipids on your skin caused by an imbalance in your cellular disposal mechanisms. This build up on your skin is called lipofuscin and is generally more visible in your later years. Interestingly, it is the quantification measure used to determine the age of certain crustaceans (in the absence of bones to use for measuring age) hence the name age spots. (Referred to as senile lentigo; pl: senile lentigines)
Liver Spots is a generic term commonly used to refer to the small dark spots on your skin collectively caused by the aging process and/or sun exposure. These dark skin spots were once thought to be caused by a liver condition, hence the name Liver Spots, but there is no physiologically connection at all between age spots, sun spots, and the presence of liver problems.
Freckles are clusters of flat, circular spots on the face caused by an overproduction of melanin granules causing the outer skin to become darker generally due to sun exposure. Individuals with freckles have a lower concentration of photo-protective melanin and are more susceptible to sun burn. Freckles are a genetic predisposition and will become lighter in the winter, whereas hyperpigmentation will not. (Referred to as ephelides)
Post-Inflammatory Hyperpigmentation (PIH)
Post-inflammatory hyperpigmentation is not caused by the usual suspects (sun, age or genetics) but is caused by inflammation resulting from a trauma to which the skin was exposed to and which caused excessive irritation to the skin. PIH can result from a wide variety of causes including acne, eczema, burn injuries, scars, skin products and dermatologic treatments. PIH most commonly occur in individuals with darker skin tones and will appear as flat spots of skin discoloration caused by increased melanin production during the healing process. While PIH will generally fade on its own, it will likely take months before the skin discoloration clears if left untreated.
Keratosis is the growth of keratin on the skin caused by the skin’s keratinocytes producing more and more keratin. This is to create a barrier on the skin as protection against ongoing environmental damage to the skin caused by UV radiation, viruses, water loss, etc. The more commonly encountered keratosis are actinic (solar) keratosis, keratosis pilaris and seborrheic keratosis. All Keratosis should be carefully examined by an appropriately qualified practitioner to ensure they are not pre-cancerous before commencing any cosmetic treatment. Flat pigmented actinic keratosis and keratosis pilaris respond well to cosmetic dermatology treatments and the appearance of keratosis pilaris can improve from laser hair removal treatments. Keratosis more commonly occur in Fitzpatrick Skin Types 1 to 2.
It is challenging to differentiate between the different types of skin pigmentation disorders and what treatment, or combination of treatments, will work. A qualified treatment provider will be able to explain the subtleties to you.
Before and After Treatment Pictures
(Results may vary with each individual and are not guaranteed)
Anxiety, reduced self-esteem and depression are some of the known psychological issues that sufferers of hyperpigmentation disorders are required to cope with. No one should have to deal with such issues when many treatment options are available today to eliminate or bring under control your skin pigmentation disorders.
While there are a number of proven treatment options to reverse the skin discoloration caused by hyperpigmentation and melasma, it is important that you find treatments and procedures that are suitable for your skin type and skin condition. Talk to your skin care advisor to get an overview of all treatment options.
IPL, fractional lasers, radio frequency energy, chemical peels and pharmaceutical grade skin care products are some recommended treatment options for alleviating your melasma, hyperpigmentation and keratosis and providing you with clearer, healthier skin; and a happier disposition too.