What causes pigmentation and how can it be treated?

There may be many different causes for pigmentation. The most common being hyperpigmentation from sun damage.

Sun Damage

Most of the sun damage is done during our childhood and adolescent years but it doesn't manifest until later in life. Freckles and brown or sun spots are a result of sun damage.

In an effort to protect the skin from the damaging UV rays the body produces excess melanin in the deep layers of the skin. Over time this melanin moves to the surface creating visible pigmented areas.

To treat this kind of pigmentation, a combination of more than one, of the following treatments is recommended:

Daily Skin Care:

A salon recommended skin care range specifically formulated for pigmentation or that contains high levels of vitamin A.

IPL or Laser:

Intense Pulsed Light (IPL) or Q-switch lasers can treat hyperpigmentation by burning the pigment without damaging the surrounding skin. The pigmented area will turn dark and may lightly scab 1 or 2 days after treatment. The scab will fall off in 1 or 2 weeks. It is important not to scratch or pick at the scab and avoid sun exposure and solariums. Deeper pigmented layers will rise to the surface and must be treated again. It usually requires 2 to 6 treatments. Treatments are spaced every 4 weeks.

Skin Peels:

Superficial skin peels with glycolic acid, salicylic acid, or lactic acid can also be used in combination with some of the other methods to enhance the results.

Daily use of a broad spectrum UVA & UVB sunscreen is paramount to avoid further sun damage. It is also recommended to wear a wide brimmed hat for long periods under the sun.

Melasma

Another cause for pigmentation is Melasma. Melasma affects mainly dark skinned people and is more difficult to treat. It often occurs during pregnancy and it is caused by hormonal changes. Because Melasma usually resides in the deep layers of the skin more aggressive treatments are needed. To effectively treat Melasma it may be recommended to combine all of the treatments bellow.

Daily Skin Care:

A daily skin care programme with high levels of vitamin A

Chemical Peels:

Stronger chemical peels that can penetrate to the deep layers of the skin as well as dermabrasion can also help.

Elos IPL:

Elos IPL which combines IPL and RF (radio frequency) may also work, however it may require multiple treatments. IPL is set low to avoid burning of the surrounding skin. The IPL energy creates a path of low resistance for the RF which is not colour dependant.

Hydroquinone Therapy:

Hydroquinone therapy it is also quite effective for the treatment of Melasma. Hydroquinone is a bleaching agent that decreases the production of melanin and breaks down the melanosomes (pigment granules of the skin's pigment cells). Hydroquinone cream is applied topically to the affected area only.

Again the use of a broad spectrum sunscreen is essential.

Post-inflammatory Hyperpigmentation

PIH (Post-inflammatory Hyperpigmentation) is also a frequent cause of pigmentation. In PIH an injury in the skin causes excessive pigment production. The most common causes are acne, burns, and psoriasis and they are more often found on dark skinned people.

PIH treatment is also quite difficult because it involves a deeper layer of the skin. Treatment options are the same as in Melasma (see above).