Pigmentation

What is pigmentation?

Pigmentation is simply, colour in your skin. Your skin gets this colour through a pigment called melanin, which is produced in the melanocytes, which can begin to overproduce, and cause clusters of darker spots on the skin, known as pigmentation.

Pigmentation is one of the most common skin complaints, that affects all skin types, and it normally presents itself on the face, neck, arms, and hands (although, it can occur anywhere on the body), as these are often more exposed to the sun. As we age, the risk of pigmentation increases, and so it is very important to always remember your SPF, and to consult your doctor if you are concerned by it.

What causes pigmentation

The main cause of pigmentation in the skin is damage caused by the sun’s ultraviolet (UV) rays, or from using tanning beds, as the UVA stimulates the melanocytes to manufacture the melanin pigment. The UVA is responsible for a tan, but also it can darken these uneven patches, and make them a lot more noticeable, and so it is very important to wear a sunscreen every day that is SPF 50, to prevent any further damage, and to stop the dark patches forming. These dark patches on the skin can take up to 20 years to develop, and unfortunately, if you have not been wearing your sunscreen daily, they may have already formed.

Different types of pigmentation and treatment

Melasma

Melasma is a common pigmentation disorder that affects up to 33% of the population, and it causes patches of pigmentation, that is normally darker than the persons skin tone. Although, it can affect all genders, it is more prominent in women due to the hormonal changes that a woman goes through, especially during pregnancy. Although, it can occur anywhere on the body, it can be more prominent on the face, especially on the cheeks, nose bridge, and forehead.

There are many potential triggers for melasma, including hormonal changes during pregnancy (known as chloasma), taking the contraceptive pill, and sun damage. Although, it is really important to ensure that sunscreen is used every day of the year, if you are experiencing melasma, it is especially important as the sun’s ultraviolet rays can cause the pigmentation to darken further. Sunscreen, however, does not protect your skin from the UV rays completely, and so you should wear a wide brimmed hat when outside, and wear protective clothing.

If you are experiencing melasma, it is important to speak to your doctor as they can decide the right course of treatment. Hydroquinone is normally, the first line of treatment for melasma, which works by lightening the colour of the skin patches over time, but there are other creams that may be suggested. If these do not work, microdermabrasion, chemical peels or LED light therapy may be used.

Freckles

Freckles are a form of pigmentation, where the skin produces too much melanin, but it does not spread it evenly, causing these little areas of discolouration. These freckles are completely benign and nothing to be concerned about, however you should always protect yourself with a sunscreen of SPF 50.

There are 2 types of freckles, one that appears due to sunlight exposure in the summer (known as ephelides freckles) and freckles that appear much darker, and they are more permanent (known as lentigines freckles). There are ways to reduce the appearance of freckles, including laser pigmentation removal, however, if your freckles are concerning you, visit your dermatologist or doctor to discuss your treatment options.

Post Inflammatory Hyperpigmentation (PIH)

Post-inflammatory hyperpigmentation happens where the skin produces extra melanin due to injury or irritation, and the most common cause of this is acne, eczema, and any other skin irritating conditions. Although, post-inflammatory hyperpigmentation can affect people of all ages, and genders, it is more prevalent in people with darker skin tone as the skin naturally contains higher amounts of pigmentation.

Although, areas of post-inflammatory pigmentation can fade on their own without treatment, there are some skincare ingredients that may reduce the appearance of the spots if they are superficial, including hydroquinone, azelaic acid, retinoids, salicylic and glycolic acid. Post-inflammatory hyperpigmentation that goes deeper into the skin may be more difficult to treat, and unfortunately there is no quick fix for these marks, aesthetic treatments like chemical skin peels, microdermabrasion, and derma pen may help to improve the appearance of the hyperpigmentation, however, always speak to your doctor or dermatologist to determine the best course of action, as this usually involves a combination of treatments.

Sunspots

Sunspots are a form of hyperpigmentation that are completely harmless, benign, and non-cancerous and so they do not need treatment unless they are causing you concern. They present themselves as flat dark spots that are caused by exposure to the sun, and they normally appear on the face, shoulders, arms, and hands as these normally get the most sun exposure.

The only way to prevent sunspots, is to protect yourself from the sun’s ultraviolet rays, by using a high SPF sunscreen (ideally SPF 50), avoiding tanning beds, and covering up using clothing.

If the appearance of sunspots does concern you, there are treatments that can reduce the appearance, including plasma pen, chemical skin peels and skin rejuvenation using lasers. It is always recommended to discuss treatment plans with your dermatologist or doctor, to see why treatment would be best for yourself.