Hyperpigmentation, also known as age spots, liver spots and “the mask of pregnancy”, is a common skin condition which affects men and women of all skin tones. The issue commonly presents as brown, tan or bluish marks on areas of the body most frequently exposed to sunlight, such as the face, hands and chest.
The condition of our skin and the evenness of our complexion form the markers of health and beauty that others use to make judgements about our age, attractiveness and even our professionalism. While unwanted pigmentation is usually harmless to health, the ageing effects of uneven skin tone may prove taxing on our feelings of self-esteem.
Time and continued UV exposure only exacerbate this skin problem, so it is recommended that the assistance of an experienced skin care practitioner be sought out as soon as dark spots are noticed for the best chances of a successful treatment outcome.
So, how does Hyperpigmentation occur?
Hyperpigmentation is caused by excess production of melanin, our skin’s natural pigment.
Located within the lower layer of the epidermis melanocytes are our bodies’ melanin-producing cells. Inside these melanocytes are sub-units called melanosomes which the body uses to synthesise, store and transport melanin to the outer layers of the skin.
When skin becomes inflamed by factors such as UV exposure, the enzyme tyrosinase converts an amino acid called tyrosine into melanin. The melanosomes then pass the melanin through the melanocytes to the outer layers of the epidermis. This process, known as melanogenesis, sometimes results in an over-supply of pigment, which we then experience as dark spots or brown patches on the skin.
Causes
Unwanted pigmentation may occur due to a variety of physical and environmental factors. Sun exposure is the most common, but the condition may also be triggered by stress, medications, diet, oral contraceptives, pregnancy, menopause or by lifestyle choices such as smoking.
Following an acne breakout, insect bite, burn, injection or trauma caused by harsh skin care treatments, unattractive marks known as Post Inflammatory Hyperpigmentation (PIH) may also occur.
Prevention
It is vital to protect skin from the sun at all times to prevent the appearance of hyperpigmentation and halt further darkening of an existing condition. Sun protection with a minimum SPF30 should be applied every day before sun exposure, and a wide brimmed hat is recommended as a way to further diminish the risk of UV damage.
It is advisable to choose a physical sunscreen over a chemical formulation. Physical sunscreens contain zinc oxide or titanium dioxide, ingredients which act as physical barriers to the sun’s damaging rays. Chemical sunscreens have been known to trigger excess melanin production and are therefore best avoided for those looking to avoid unwanted dark patches.
Treatment
Because of the prevalence of this condition, there is a diverse range of treatment options available to assist you in reducing the appearance of unwanted colouration on the skin.
A professional skin clinic can tailor a range of treatments and at-home skin care products to deliver the best results for your skin’s unique requirements. Some of the best treatments currently available for this condition include: The use of a Dermaroller, Intense Pulse Light (IPL), LED, Iontophoresis, Ultrasound, Skin Penetration, Skin Peels and Microdermabrasion as well as a range of topical treatments.
A successful treatment plan will frequently include a combination of a pigment inhibitor, exfoliation, melanogenesis inhibitors and penetration enhancers.
Medical Grade Skin Care Products
Skin Lighteners: Tyrosinase Inhibitors
Tyrosinase inhibitor products are used to disrupt an enzyme called tyrosinase and prevent it from causing an over-production of the melanin (pigment) which leads to darker areas on the skin.
For many years, hydroquinone has been prescribed as a solution. More recently, however, skin care clients have been advised to take extra precautions to avoid the side effects associated with this ingredient or to choose an alternative solution.
Other highly effective tyrosinase inhibitors include: kojic acid, mulberry extract, octadecenedioic acid, tetrahydrocurcumin (THC), azelaic acid, arbutin (bearberry extract), liquorice, N-acetyl glucosamine and burdock root extract.
Most pigment inhibitors will require application both morning and night, and it is critical to be diligent in your application to achieve noticeable and lasting results.
Exfoliation
Exfoliation is a process which removes dead skin cells (and excess melanin) to reveal new, brighter skin. It is a crucial step in any good skin care regimen, but particularly in the treatment of excess pigment.
Microdermabrasion is a widely available, non-invasive and effective exfoliation treatment which uses a combination of tiny crystals and a specially designed vacuum system to buff the skin and remove dead cells. When performed by a trained practitioner, microdermabrasion brightens the skin, stimulates collagen production, gives a smooth appearance and assists in the absorption of the active ingredients in your specialist skin care products.
You may also choose to utilise treatments and products that harness the power of ingredients such as lactic acid, enzymes, trichloroacetic acid (TCA), salicylic acid, peptides and retinol.
Chemical Peels
A chemical peel improves the appearance of skin hyperpigmentation problems. The skin peel treatment exfoliates layers of the skin with a mixture of acids. These peels increase cell turnover and help to exfoliate the skin. A chemical peel can be applied to any area affected by hyperpigmentation on the face, neck, hands and chest.
Each chemical peel has a different potency which provides different skin pigmentation treatment results. Mild, medium and deep all use different chemicals which vary the effects. For deep skin peels, the recovery time is longer, but they will more aggressively reduce the signs of hyperpigmentation in the long run.
Of course, after treatment, it’s recommended that you stay away from direct sunlight, so you don’t expose your fragile skin to a pigmentation stimulant.
The Dermaroller: Skin Penetration
Don’t let the term skin penetration frighten you! The Dermaroller treatment is safe and effective. It involves passing a hand piece over the skin that suffers from hyperpigmentation. Tiny needles then penetrate the sun-damaged skin. Reaching the second layer, the needles trigger the production of new collagen as the old collagen is damaged.
This skin pigmentation treatment method activates the skin in its production of vitamin A and C oils which help produce collagen. The collagen production is a result of the inflammatory caused by the needles.
The new collagen then takes around 90 days to produce results, and you should begin to see improvements gradually take place over time.
Penetration Enhancers
There are many products and treatments available to increase the ability of targeted ingredients to reach deep into the skin to more effectively treat your condition.
Ultrasound technology may be used to create micro-vibrations on the skin, forming small gas bubbles which then open space between skin cells so active ingredients may penetrate more easily.
Individual areas of pigment may be targeted with the use of a method known as Specific Iontophoresis. This technology uses safe electrical currents to better help water based products penetrate the layers of the skin.
Skin needling has also been shown to be effective, and ingredients such as alpha bisabolol or kojic acid also help to achieve better skin penetration.
Melanogenesis Inhibitors
As discussed earlier, melanogenesis is the process by which your body produces melanin, or pigment, in the skin. A melanogenesis inhibitor, therefore, is a product or treatment which blocks the melanin from being transferred to other skin cells, eliminating further discolouration.
Products in this category may include ingredients such as liquorice, niacinamide, Oligopeptide-34, Vitamin C or Zinc glycinate.
To achieve the brightest results, it is essential to remain consistent with both your professional treatment appointments and at home skin care program. You should expect to apply your prescribed skin care products for a minimum of four to eight weeks before experiencing significant changes in the depth of colour. It is also important to be aware that treatment areas may become much darker before becoming lighter, as you accelerate the body’s natural processes.
With consistency, sun protection, targeted ingredients and professional support you can successfully treat your hyperpigmentation and enjoy a beautiful, clear complexion.