The Doctor-approved guide to treating pigmentation

As Winter draws in, do those dark patches on your skin that definitely aren’t moles or freckles, seem to become far more prominent now your Summer tan has faded? Well, you might have skin pigmentation, a common skin complaint that results from an increased production of pigment in areas of the skin.

However, just because we are barely spending any time outside doesn’t mean you can’t catch the sun through your window and on your balcony/in your garden (if you’re lucky enough to have one!). Also known as dark spots, age spots or sun spots, we’ve called upon Dr Rekha Tailor to explain exactly what pigmentation is, how to treat it, how to prevent it and what products to use.

What is pigmentation?

Pigmentation, or hyperpigmentation, is the overproduction of melanin (the natural pigments produced in our cells responsible for skin and hair colour) within specific areas on the skin, creating darker spots compared to the overall skin tone. This can result in an uneven complexion.

The most common causes of hyperpigmentation — which can affect people of all skin tones in varying degrees — are:

• Sun Exposure: The sun’s UV rays hitting your skin triggers extra melanin production to defend your skin from damage. That extra melanin is what gives you a tan. However, when sun exposure is frequent or excessive it can make dark “sun” spots appear.

• Melasma: Often referred to as the “mask of pregnancy,” melasma is characterized by brown patches that can commonly form in women during pregnancy. This type of hyperpigmentation most often occurs in women, but can also occur in men. It is thought to be triggered by a combination of sun exposure, genetics, and hormonal changes.

• Inflammation: Skin trauma — such as acne, eczema, bug bites, cuts, scrapes, even scratching or friction — can set off inflammation. Inflammation, in turn, can send pigment-producing cells into high gear, leaving behind a dark spot after the injury has healed.

• Medical Conditions or Medication: Hyperpigmentation can also be due to Addison’s disease, an adrenal gland disorder that can increase melanin production. Certain drugs, including antibiotics and some chemotherapy drugs, can cause hyperpigmentation.

What professional treatments are best?

There are plenty of pigmentation treatments to choose from and treatment options will differ depending on skin type and type of pigmentation. We’ve run down our top 3 in-clinic options below

Cosmelan Mask Treatment

The Cosmelan Mask Treatment incorporates an exclusive combination of active ingredients with proven efficacy, which act on all stages of the hyperpigmentation process to eliminate existing hyperpigmentation’s, preventing both their reappearance and the appearance of new dark spots giving both a comprehensive and effective result.

It is a great option for people with darker skin tones who are experiencing pigmentation and can be used to treat a variety of skin conditions including:

• Melasma
• Chloasma
• Lentigo
• Sun-damaged skin
• Acne
• Brown spots

It effectively combines professional medical treatment and at-home maintenance for rapid whitening of all types of skin blemishes at any time of the year. There is a small amount of downtime from the treatment which may include redness and flaking.

Chemical Peels

Patients with deep pigmentation, which is usually to due hormonal imbalance such as melasma, or post-inflammatory hyper-pigmentation due to inflammation, can be treated with deep skin peels.

A chemical peel is a chemical exfoliation specifically tailored to suit your skin’s needs. It rejuvenates the complexion, restores glow and lustre to the skin and helps to improve the skin’s overall health and appearance. A chemical peel works by gently removing a controlled amount of the skin’s outer layers, including the dead cells on the surface which promotes regeneration and repair. They can be used to treat a variety of skin conditions including:

• Sun-damaged skin
• Brown spots
• Melasma
• Acne scarring
• Redness
• Uneven skin tone
• Dry skin

We tailor peels to the individual, dependent on whether a gentle or more dramatic result is desired and on whether you can accommodate shedding of the skin or prefer a peel procedure to go unnoticed. The stronger peels penetrate more deeply and can achieve more dramatic results including skin tightening and reduction of sun damage, pigmentation, fine lines, open pores and scarring. However, some visible peeling occurs for 3-7 days after the procedure.

Laser

Compared to Peels, Laser treats only superficial pigmentation such as that caused due to UV damage.

Excel V+ delivers wavelengths to targeted areas and these wavelengths are absorbed by the chromophores in our bodies (the parts of a molecule responsible for its colour), meaning it seeks out and removes the reds, browns and purples of the skin. These wavelengths are also absorbed by melanin, oxyhemoglobin and water, helping to address fine lines and wrinkles.

When treated the pigment absorbs the light and becomes oxidised and will turn darker. This will then flake off over the week after treatment and reduces dark patches on the skin. These will appear darker immediately after the treatment and will initially develop a small crust before falling off leaving you with more even skin.

The treatment is not painful and at most you may notice slight discomfort. Depending upon your skin type (and the lesion in question), there is redness and swelling in the treated area for up to 2-3 days after treatment. However, we can significantly reduce this and enhance the healing by having a LED Light Therapy immediately after the laser treatment.

The treated area may also appear darker for 5-7 days after treatment, but this will clear shortly afterwards. This is normal since your body breaks down and absorbs the melanin.

What at-home treatments are best?

The best at-home skincare ingredients to treat pigmentation are the almighty skin-hero Retinol, to promote cell turnover and the production of healthy skin and Vitamin C, a potent antioxidant to best prepare skin for any oxidative stress caused by environmental aggressors like UV rays. However, you shouldn’t ever jump into using Retinols, until you have effectively repaired your skins barrier. You can do this by using the following system:

ZO Skin Health Skin Brightening System

ZO Skin Health Skin Brightening System is designed for the visible treatment of hyper-pigmentation without the use of hydroquinone and retinol. This is the perfect treatment not only for those starting cosmeceuticals but also those wanting to prepare their skin for laser treatment to treat and reduce the risk of hyper-pigmentation. The ZO Skin Brightening System contains the following:

• Gentle Cleanser (60ml) – which is perfect for all skin, especially pigmented skin.
• Exfoliating Polish (16.2g) – is included to help rid your skin of dead cells and pigmentation.
• Complexion Renewal Pads (30 pads) – to remove dirt and oil and tackle oil production.
• Brightalive Skin Brightener (30ml) – to remove pigmentation and brighten the skin.
• Daily Power Defence (30ml) – which restores your skin’s natural barrier function, contains antioxidants, repairs your skins DNA and protects the skin against free-radicals such as pollution.

It is ideal for non-specific visible discolouration (freckles, liver spots or uneven tone) and for brightening the skin. This system also reduces the appearance of fine lines and wrinkles.

Once your skin has repaired barrier function, then you can start introducing other products. ZO Skin Health Brightening System is further complimented by:

• ZO Retinol Skin Brightener: uses a unique and potent blend of retinol, vitamin c, antioxidants and melanin inhibitors, this is a comprehensive multi-action formulation to minimise redness and to brighten and even the skin tone
• ZO Skin Health C Bright 10% Serum: uses stabilised Vitamin C Serum to brighten the skin and smooth texture. It contains skin lipid replenishers to ensure the skin barrier remains balanced and protects the skin from environmental damage while also preventing new melanin pigment from forming new hyper-pigmentation.

How to prevent pigmentation

With UV rays being one of the main causes of pigmentation, users of sun beds, or fans of sunbathing are more likely to develop pigmentation. Some skin types are more prone to pigment than others due to the amount of melanin (pigment) within the skin and treatment options will differ depending on skin type and type of pigmentation.

Therefore, the most effective way to prevent sun-induced discoloration is to diligently apply a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or greater, every day, even on cloudy or cool days.

For the pigmentation caused by inflammation, such as acne, the best thing you can do is to leave it be. Scratching and picking at a spot or bite will only increase the inflammation that’s responsible for skin discolouration.