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The Problem With Hyperpigmentation

30/07/2015

Sun damage, hormones, inflammation - the causes of hyper-pigmentation are almost as numerous as the treatments on offer to correct it. Recent reports show that pigmentation treatments account for around 10-15% of all clinic treatments, so how to we go about dealing with this common aesthetic concern. 

Hyperpigmentation - or hyperpigmentation disorders - are caused by overproduction of melanin by the pigment cells, called melanocytes (broadly referred to as 'melasma'). This is associated with hormonal changes (including pregnancy), certain medications and sun exposure. Additionally, increased pigment in the skin can be caused by post-inflammatory hyperpigmentation, such as that left by acne, scars, psoriasis and previous aesthetic treatments. 

Exposure to sunlight triggers melanin production in order to protect the skin from harmful UV rays so excessive sun exposure can result in increased melanin production, which leads to pigmentation. According to research patients presenting with UV-induced hyperpigmentation tend to be in their 40's and 50's, having spent many years tanning, and likely much of that time ill-informed about the risks associated with sun exposure and sunbeds. Patients seeking treatment for hyperpigmentation more generally range in age from early 30's to late 50's. Pigmentation can vary in severity, for example the extent of coverage on the four areas of the face (forehead, left cheek, right cheek and chin) and the darkness of the hyperpigmentation.

Many of our clients are concerned specifically about premature ageing, focusing on the appearance of lines and wrinkles rather than any uneven pigment in the skin. We always advise that the condition of your skin (texture, uneven skin tone, pore size etc) are just as important when looking to treat premature ageing as lines and wrinkles, age and sun spots are just as much of a tell-tale sign of ageing as wrinkles are.

The good news is that due to advances in technology nowadays we are in a position to be able to treat hyperpigmentation. Treatment falls into 3 main areas: creams and products, laser treatment and skin peel treatment. A combination of topical therapy comprising of hydraquinone, tretinion (prescription only) and a corticosteroid have been found to be very successful in treating melasma. We would encourage the use of home use products alongside in clinic treatment to get the best results possible.

Chemical peels in various formulations such as Glycolic, Salicylic and Lactic acids are often used as in-clinic treatment in combination with longer-term topical creams that clients use at home. They allow us to strip layers of skin that are effected with hyperpigmentation to reveal an even skintone underneath.

Lasers are commonly used to treat clients with prematurely aged and sun-damaged skin. Melanocytes grow like branches under the skin, which appear as freckles or pigmentation on the skin, so the source of the problem is not always directly beneath the area of pigmentation - it may have spread to 5-6cm further out under the skins surface. For this reason we treat the whole area (i.e. full face, decolletage or hands), rather than just pigmented spots. Lasers have been at the forefront of removing skin pigment for several years to target hyperpigmentation. They are successful in picking up darker pigments in the skin and breaking them down for the body to dispose of, similarly to how Laser hair removal works in breaking down the hair folicle as it is darker than the skin colour. We use a number of Lasers at Skin Health Spa to tackle pigmentation including: Cynosure Emerge Fractional Lasers, The Clear + Brilliant Laser, IPL lasers and Cynosure Elite Lasers. 

Whatever the cause of hyperpigmentation, exposure to UV radiation generally worsens the condition. Consequently we recommend our clients take extreme care with sun exposure and wear a high rating daily SPF (30+ with 5 star UV rating). This should be applied liberally throughout the year in all weather. We advise against the use of sunbeds and sun exposure and recommend a high SPF that covers both UVA and UVB, along with a hat and dark glasses, and covering up in the sun. 

Technologies are improving all the time and along with our greater understanding of the mechanisms that cause melasma there is no longer a need to cover pigmentation with makeup. Book a free consultation with one of our skin experts at your nearest Skin Health Spa clinic on 0800 24 25 145 to find out what treatments will help to treat your pigmentation so you can dare to go bare with confidence.