Pigmentation Treatments with Skin Medical

Pigmentation is caused by the distribution of melanin, a brown pigment molecule, under the skin. This pigment protects skin cells from the sun. People tend to favour even skin tones, regardless of whether they are light or dark. There is evidence that evenness of colouration has a significant impact on how young or attractive a face is considered to be – even more so than the presence of wrinkles or lines.

UVA reaches the skin all day, even passing through clouds and glass windows. While UVA alone doesn’t cause sunburn, it breaks down the collagen and elastin that keep the skin firm and springy. Up to 80% of what are considered to be the signs of ageing – wrinkles, age spots, and rough texture – result from exposure to UVA. The skin protects itself against UVA by darkening the melanin, but this does not stop the ageing process.

Age spots are skin damage caused by everyday exposure to UVA light over a lifetime. Patches of melanin cluster under the skin, showing up as an uneven pigmentation pattern. This leads not only to age spots but also to wrinkles, rough texture, and possibly skin cancer. For the best looking and healthiest skin, high-factor sunscreen is recommended at all times.

 

• UVB Light

UVB light can burn the skin if it is not protected with sunscreen. The skin tries to protect itself against UVB by producing more melanin, resulting in a tan or freckles. While a tanned appearance may be fashionable, it is actually a sign of skin damage. The application of fake tan is a much safer way to achieve this look. The incidence of skin cancer has more than doubled since the 1990s, highlighting the importance of taking this issue seriously.

It is important to ensure that age spots are actually age spots and not signs of skin cancer. Always seek the advice of a medical practitioner if you are unsure. For more information, visit the Skin Cancer Foundation website.

• Melasma

Melasma is another condition that can darken the complexion, often forming a butterfly-shaped patch of colour across the face. It is caused by hormonal fluctuations, which can result from hormonal contraception, pregnancy, or hormone replacement therapy (HRT). Unfortunately, melasma does not go away completely and can only be managed through treatment by an experienced practitioner.

• Post-Inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation is a condition where brown spots appear as a result of acne scarring, eczema, or even overly aggressive pigmentation treatment with lasers. This occurs because inflammation encourages melanocytes (the pigment-producing cells in the skin) to create more pigment.

While hyperpigmentation refers to skin that is darker than the surrounding areas, hypopigmentation is the term used when the skin is lighter than the surrounding area. Vitiligo is an autoimmune condition where the skin loses its colour in patches and is the most prevalent example of depigmentation. It’s important to note that the congenital disorder albinism is technically a complete absence of melanin (amelanosis) and should not be confused with depigmentation that occurs over time.

Depigmentation results from a lack of melanin in the affected area, melanin inactivity, or a combination of both. Various factors can cause this, such as trauma or a chemical reaction. With vitiligo, there is also a genetic component. Over-treatment with laser or skin peels, or any other form of skin resurfacing such as dermabrasion, can also cause hypopigmentation.

Skincare treatments for hyperpigmentation work best when used consistently and in conjunction with daily sunscreen application. Here are a few products and ingredients that can help:

• Vitamin C, Liquorice, Azelaic Acid, and Kojic Acid: These ingredients can inhibit the action of an enzyme called tyrosinase, which is necessary for the formation of pigment.
• Niacinamide: A version of vitamin B3, niacinamide prevents the transfer of pigment from the cells that make it (melanocytes) to the skin cells where it is stored (keratinocytes).
• Exfoliating Acids: Exfoliating acids encourage the shedding of outer, pigmented layers of skin, allowing fresher, clearer skin to grow through. These include alpha-hydroxy acids like glycolic acid (stronger) and lactic acid (gentler), or beta-hydroxy acid such as salicylic acid.
• Retinol Creams: Retinol speeds up the turnover of skin cells, improving pigmentation and also enhancing skin texture and reducing fine lines. However, it can cause irritation, especially in higher concentrations, so caution is advised.

Some over-the-counter products have been shown to reduce hyperpigmentation and fade age spots, but they are not as powerful as prescription lightening agents and have a lower risk of irritating the skin.

• Prescription-Only Creams: A prescription-only cream containing 4% hydroquinone is backed by positive research. It is applied in the morning and at night and will take at least eight weeks to work.

Don’t forget high-factor sunscreen – SPF30 in winter and SPF50 in summer. Reapply it during the day to maintain protection.

For those seeking more intensive solutions for hyperpigmentation, certain light treatments such as Intense Pulsed Light (IPL), laser therapy, and skin peels can be very effective, as can microneedling. Sunscreen remains essential, particularly for procedures that can leave the skin more sensitive to light for a while.

• Microneedling

Microneedling is used as a skin-tightening, collagen-boosting treatment, but it can also improve pigmentation problems. The process of healing the tiny wounds made by the treatment creates new, fresh-looking skin and clears away the old, over-pigmented skin on the surface. To see the most benefit, a course of treatment is usually required, often consisting of four to six sessions, each spaced a month apart.

• Intense Pulsed Light and Laser Therapy

Intense Pulsed Light (IPL) and laser therapy are advanced skin treatments used to address various skin concerns, including pigmentation, sun damage, and signs of ageing. Both therapies use light energy to target specific areas of the skin, promoting regeneration and achieving a clearer, more even complexion. In terms of pain, patients usually tolerate Intense Pulsed Light (IPL) well. While it is not pleasant, it is not severe either. The intensity can be adjusted if the patient finds it uncomfortable. Laser therapy is generally considered more painful, but this varies depending on the energy levels used. Most lasers have a built-in cooling system to physically cool the skin, and anaesthetic cream can effectively numb the area. 

• Skin Peels

Skin peels work by applying ingredients that encourage the shedding of the outer layers of the skin, effectively removing pigment from the surface layers. While the procedure might sound harsh or alarming, advancements in recent years have made it much gentler. Some peels don’t even cause noticeable peeling, as they work beneath the surface to promote regeneration.

More aggressive peels are still available and may make the skin red, tight, and prone to flaking for up to 10 days after the procedure. These stronger peels are typically used for more severe skin concerns and can result in significant improvement.

The choice of treatment depends on the type of pigmentation. Melasma, for example, usually sits more deeply in the skin, so surface treatments like laser or IPL may not be effective. At Skin Medical, Dr. Sabika Karim offers advanced treatments tailored to your specific needs to address hyperpigmentation and improve your skin’s appearance. Contact our team today to learn how we can help you achieve a clearer, more radiant complexion.

Acne can leave behind post-inflammatory hyperpigmentation (PIH), which are flat spots of pink, red, brown, or black discolouration. Skincare treatments can help with PIH, as can laser and skin peel treatments. Laser therapy can be particularly helpful in softening the pitted scars often left by acne, stimulating the growth of new collagen and elastin in the skin below the scar, and breaking up the pigment under the skin so the body can clear it. Microneedling has also been found to be effective.

It is advised to allow two weeks after the procedure before adding more filler to the area. This allows the enzyme to fully dissolve the original filler as desired, ensuring optimal results.

Dissolving fillers is generally considered safe, particularly because the dissolving agent, hyaluronidase, is similar to the fillers themselves and is derived from naturally occurring substances. However, like any medical procedure, it is safest when performed by an experienced injector like Dr. Sabika Karim.

Despite the overall safety, there is a slight risk associated with the treatment, especially if there is an undisclosed allergy to hyaluronidase that could trigger a reaction. In very rare cases, or if the procedure is performed carelessly, the treatment might affect more than just the hyaluronic acid from the dermal filler. It could potentially dissolve some of the natural hyaluronic acid already present in the skin, although this is an uncommon occurrence.

The key to a safe and effective procedure is to have it performed by a suitably qualified professional. A thorough consultation is necessary before any treatment is administered to confirm medical suitability. Each patient’s treatment is personalised, reflecting their individual needs and circumstances.

For personalised advice and to ensure the safest possible treatment, contact our team today and let us help you achieve your desired results.