Pigmentation happens when your body’s melanin production is out of balance. Special cells called melanocytes are responsible for making melanin – the natural pigment in your skin. When your melanocytes are damaged or unhealthy, it affects your melanin production. Often this means the cells make too much melanin and your skin gets darker in places.
There are various types of pigmentation, some of which are harder to treat than others, but there are also various ways to tackle to problem. So first of all, what causes this condition and secondly, what can you do about it?
There are various types of pigmentation
Hormonal pigmentation
Hormonal pigmentation can occur whenever your estrogen levels increase, for example when you take birth control pills or during pregnancy. “Hormonal Pigmentation occurs in a symmetrical pattern on the forehead, cheekbones and along the jawline,” explains Dr Maureen Allem, a medical doctor and specialist in anti-aging procedures, and the founder of Skin, Body & Health Renewal.
Hormonal Pigmentation occurs in a symmetrical pattern on the forehead, cheekbones and along the jawline
“Discontinuing the use of contraceptives rarely clears the pigmentation and it can last for many years after discontinuation,” Dr Allem explains. “The pigmentation from pregnancy is usually symmetrical, meaning if it shows up on one cheek, it usually shows up on the other. This type of pigmentation is a dynamic chronic condition that has to be managed lifelong by applying active products that regulate the pigmentation process.”
Post-inflammatory / hyper-pigmentation
Post-inflammatory or hyper pigmentation usually appears in the areas where you suffer acne or breakouts, dermatitis or any type of scratch-irritation.
This type of pigmentation is more prevalent among darker skin types because melanocytes are more active in dark skins. “Melanocytes produce melanin in the skin,” explains Dr Allem. “The more melanin found in the skin, the darker the skin. The production of melanin is induced by exposure to the sun.”
Lara Wicksteed, Key Accounts Manager for Dermalogica, adds that in darker and black skin “any inflammation or injury to the skin is almost always accompanied by alterations in pigmentation – either an increase or decrease in pigmentation.” Wicksteed also adds that this type of pigmentation tends to solve itself. “If the pigmentation is due to inflammation of the skin it is just a matter of time before it clears on its own,” she says
Dermal pigmentation
UVA rays from the sun stimulate the development of melanin. “Chronic sun damage causes discrete pigmentation, which appears as sun spots on the temples, nose and the cheek side of the face,” explains Dr Allem. “The deeper the pigment is, the more difficult it is to treat.”
Chronic sun damage causes discrete pigmentation, which appears as sun spots on the temples, nose and the cheek side of the face
What can I do?
“Treating pigmentation depends on how deep the pigment is in the skin and what kind of pigmentation it is,” explains Dr Allem. “Dermal pigmentation is the most common form and is easily treated with a combination of superficial chemical peels, microdermabrasion, Limelight or IPL laser procedures together with a home topical cream and sun block.”
The traditional way of treating pigmentation is with hydroquinone based products, used to bleach the darkened pigment. However, these should only ever be used under a medical doctor’s supervision as it can cause serious skin damage.
“Still, despite best efforts with bleaching agents and exfoliation treatments, pigment can be stubborn and long lasting,” says Dr Allem. “The challenge is to improve pigmentation, fade the dark spots and heal it without causing any irritation and redness which can result in further hyper pigmentation.”
The challenge is to improve pigmentation, fade the dark spots and heal it without causing any irritation and redness which can result in further hyper pigmentation
Topical treatments for pigmentation
Start with sunscreen
“Sun exposure is one of the primary causes of the skin discoloration, and other treatments can’t keep up with the sun’s daily assault on the skin,” explains Paula Begoun, author of Don’t Go to the Cosmetics Counter Without Me. “Before you look at any other option for brown or ashen skin discolorations, start with applying sunscreen and reducing sun exposure.”
Before you look at any other option for brown or ashen skin discolorations, start with applying sunscreen and reducing sun exposure.
When choosing a sunscreen, make sure it is broad spectrum, meaning it protects against both UVA and UVB damage. Many sunscreens now include their UVA rating at the back of the product. In South Africa, you should be wearing at least SPF20.
Choosing the best ingredients
Dr Allem recommends that you look for products that contain Arbutin, bearberry, cucumber extract, hydroquinone (to be prescribed by a medical doctor), kojic acid, licorice extract, magnesium ascorbyl phosphate, mulberry extract, niacinamide, retinol, resorcinol, beta hydroxyl acid, Vitamin C and azelaic acid.
Exfoliants are also important to increase the effectiveness of a product. “AHAs or Alpha Hydroxy Acids, including lactic acid and glycolic acid, can be very effective for improving the overall appearance of sun-damaged skin and possibly helping other ingredients penetrate skin better,” says Begoun.
AHAs or Alpha Hydroxy Acids, including lactic acid and glycolic acid, can be very effective for improving the overall appearance of sun-damaged skin
Of course, the extent of the damage will influence the outcome of treatments. “The success of the treatment will depend on the extent and depth of the pigmentation,” explains Wicksteed. “At times topical serums are able to halt or reduce the pigmentation but are unable to clear it completely.”
Clinical treatments for pigmentation
Beta Hydroxy Peel
Dermal pigmentation is the most common form of pigmentation and is easily treated with a series of superficial chemical peels like the Beta Hydroxy Peel, says Dr Allem. According to her, this will substantially improve uneven pigmentation and it is suitable for all skin types and colours.
Limelight
“The Limelight procedure can be customised to your skin type and can specifically target the brown pigmentation in the epidermis,” explains Dr Allem. “Immediately after the treatment, your brown spots will start to darken and your skin may be slightly red. Within one to two weeks, the darkened spots will flake off and fade.” This procedure is not suitable for dark skin types.
Laser Genesis
Another treatment option Dr Allem recommends is the non-invasive Laser Genesis treatment, a long pulsed laser that can penetrate into the dermis to reach the pigment. “The Laser Genesis procedure gently heats the dermis causing cavitation bubbles, which disrupt the unwanted dermal pigment, breaking it into smaller particles which are able to move upward to the epidermis where it can be easily removed with exfoliation,” says Dr Allem.
Be careful about choosing dangerous products
Wicksteed warns that using the wrong types pigmentation treatments can cause serious, long-lasting or permanent damage, or can even put you at risk of cancer.
Take care
Products that cause irritation to the skin will cause more inflammation and irritation, resulting in more pigmentation.
Most products from street vendors and salons contain high concentrations of hydroquinone, steroids, mercury and Phenol.
Steroids can cause acne, pigmentation, stretch marks, skin infections, excessive hair on the skin, thinning and easy bruising of the skin, which is irreversible. Hydroquinone can cause irreversible damage to the skin and a condition called ochronosis.
Mercury can affect pregnant women and cause neurological disorders in the baby.
Prolonged use of skin lighteners may result in skin cancer.
Unsupervised use of skin lighteners is very dangerous and may result in irreversible damage to the skin.
Unsupervised use of skin lighteners is very dangerous and may result in irreversible damage to the skin
Be cautious of the following ingredients
Mercury: dangerous.
Hydroquinone: should only be used under the supervision of a dermatologist.
Phenol: dangerous in high concentrations.
Corticosteroids/steroids: For specific skin conditions like eczema – should only be used under the supervision of a dermatologist.
Look out for skin brighteners vs. skin lighters.
Products worth trying:
1. Eucerin Even Brighter Dark Spot Corrector (R169,99, eucerin.co.za). This targeted treatment can be applied to specific problem areas. It contains B-Resorcinol (4-Butylresorcinol) and licorice extract (Glycyrrhetinic Acid), both of which effectively inhibit tyrosinase activity, the enzyme that regulates the production of melanin. Licorice extract is also an excellent anti-inflammatory ingredient so it reduces irritation in the skin.
2. Dermalogica C-12 Pure Bright Serum (R1200, dermalogica.co.za). This serum forms part of the new PowerBright TRx range from Dermalogica, which also includes a day and night cream. I saw significant improvements in my post-inflammatory pigmentation while using this range. The serum contains a combination Oligopeptide-51 and Oligopeptide-34 that work to fight the formation of melanin, as well as rice-derived Phytic Acid, Zinc Glycinate, and Algae.
3. Optiphi Complexion Control (R990, optiphi.com). This face cream contains Retinol, as well as Vitamin C and Ellagic Acid which inhibit tyrosinase activity and suppress the formation of melanin, along with a range of antioxidants. My skin looked incredible while using this product.
4. Paula’s Choice Resist Skin Transforming Multi-Correction Treatment (R485, paulaschoice.co.za). This is a great all-rounder, targeting early-aging, acne, blackheads, pigmentation / brown spots, redness and rosacea. The hero ingredient, Azeliac Acid, has anti-oxidant and anti-inflammatory properties, targets acne and is said to improve brown spots by interrupting melanin production. The treatment also contains Beta Hydroxy Acid (BHA), an exfoliant that will target blackheads and blemishes while stimulating collagen production.
5. Estee Lauder CyberWhite HD Advanced Spot Correcting Essence (R850, esteelauder.co.za). This serum contains a good amount of Vitamin C (ascorbyl glucoside), working to lighten and brighten the skin tone, along with antioxidants and acetyl glucosamine, which can help smooth skin texture and increase moisture content.
6. Environ C-Boost clarifying cream (R309, environ.co.za). Apply this targeted treatment before your moisturizer. Vitamin C (Ascorbyl Tetraisopalmitate) improves uneven skin tone and is said to reduce UV-induced cell damage. To start off, apply this to problem spots only.
*Main image: Shutterstock; Product stills: Supplied.
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