What is Pigmentation?

Pigmentation refers to the colouring of the skin and we use this term when we talk about the topic of aesthetics. Skin gets its colour from a pigment called melanin, and melanocytes are the cells in our skin that make pigment. When melanocytes get damaged or unhealthy, such as an injury or illness, it affects the melanin production. Either hypo- (lighter) or hyper- (darker) pigmentation can be the result. Hypopigmentation is the result of a reduction in melanin production by the melanocytes, and hyperpigmentation is the result of increased production in melanin. It causes the skin to darken. Sun exposure is a major contributor to the development or worsening of hyperpigmentation. Certain conditions, such as pregnancy, may cause melanocytes to produce more melanin, creating hyperpigmentation. Certain prescription drugs can increase sensitivity to sunlight and thus cause hyperpigmentation.

Types of Hyperpigmentation:

Melasma – is caused by hormonal changes and may develop during or post pregnancy. This condition is characterized by brown or tanned patches. Melasma is most common on the face but can appear anywhere on the body.

Sunspots and Age Spots – these are also called solar lentigines and liver spots. They are very common and are related to excessive sun exposure, sun damage, over time. They appear most often on sun exposed areas such as the face, hands, and neck.

Post-Inflammatory Hyperpigmentation (PIH) – this is a direct result of an inflammation or injury to the skin. Common everyday cause of this type is acne. However aesthetic treatments such as chemical peels and/or laser modalities such as laser hair removal etc., can trigger PIH if proper precautions are not considered to prevent such occurrences.

Types of Hypopigmentation:

Skin Damage Hypopigmentation – trauma to the skin, such as skin infection, blisters, burns or other trauma, may increase the risk of a loss of pigmentation in the affected area.

Vitiligo – is characterized by smooth, white patches on the skin and can appear all over the body. It is an autoimmune disorder in which melanocytes are damaged.

Albinism – is a rare genetic disorder caused by the absence of an enzyme that produces melanin, resulting in complete lack of pigmentation in skin, hair and even eyes.

How is Hyperpigmentation Treated?

For more moderate to severe cases of hyperpigmentation, such as melisma, topical prescription medication can be prescribed by a doctor to treat the condition. This medication usually contains hydroquinone, which lightens the skin. This prescription should only be used under the care of a medical practitioner as there can be adverse effects if proper directions are not followed on using the medication.

Other treatments include topical retinoids, which are derived from vitamin A. They have a small molecular structure that allows them to penetrate deeper into the skin and treat the layers below the epidermis. Retinoids, such as tretinoin, are stronger and therefore require a prescription by a medical practitioner. Retinols are another form of retinoids that are effective but not as strong.

Sunscreen is the single most important factor not only improving hyperpigmentation but also preventing it and preventing it from getting worse. Therefore using sunscreen on a daily basis and reapplying it while outside for prolonged periods is recommended.

Additionally, acids that you apply topical can help reduce or lighten hyperpigmentation, as they work by exfoliating the epidermal (top) layer of your skin. Popular acids that are listed as ingredients in skincare products include AHAs (glycolic, lactic, etc.), azelaic acid, kojic acid, BHAs (salicylic acid), and vitamin C (in the form of l-ascorbic acid). Choose a product that contains an acid percentage of 10% or lower, as higher acid percentages, can cause increase risk of side effects.

Chemical peels and laser treatments, such as IPL , can also help reduce hyperpigmentation. Of note, chemical peels may not be the best treatment, if you are out in the sun on a regular basis, do not limit sun exposure, and are not diligent on using sunscreen. Skin after chemical peel treatment is more sensitive and more susceptible to UV rays and sun damage.

Ingredients that help with hyperpigmentation

In previous hyperpigmentation posts, I discussed various products or ingredients that can assist in lightening dark spots and sun damage. In addition, there are specific ingredients that can also aid in fading hyperpigmentation. What is important with ingredients and topical skincare products, is consistent and frequent application of them in order to see results. Skincare takes the longest to see results but can be just as effective as in clinic treatments as it is meant to be applied at least once a day or twice a day and for long term use. This goes a long way in overall care of your skin and its health.

So what are the top ingredients to incorporate to fade sun damage and hyperpigmentation?

Vitamin C

Vitamin C is a powerful antioxidant that helps reduce not only hyperpigmentation, but promotes collagen production, protects against free radicals and oxidative damage, promotes the skin’s healing response, and makes skin brighter. It inhibits melanin synthesis specifically helping with hyperpigmentation, as melanin is what gives our skin colour.

Arbutin

Arbutin is a derivative of a topical skin lightener called hydroquinone. It is naturally occurring and comes from the bearberry plant. Unlike hydroquinone that is harsh on the skin and causes irritation, arbutin reduces these effects by breaking down into hydroquinone after it’s absorbed in the skin. Just a vitamin C, arbutin inhibits tyrosinase, preventing excessive melanin production which ultimately shows up as hyperpigmentation.

Niacinamide

Niacinamide suppresses the transfer of melanin to the skin cells in the top layer of the skin to help brighten skin and lighten dark spots. It interferes with keratin and melanin cells (keratinocytes and melanocytes), making it difficult for melanin to form. This ingredient also helps minimize pore appearance by keeping skin smooth and moisturized.

Kojic Acid

Kojic acid is a lightening agent that comes from fungi and is a by-product of fermented foods like sake, soy cause, and rice wine. It can help reduce the appearance of hyperpigmentation by inhibiting tyrosinase like other ingredients, however, is less harsh than hydroquinone.

Retinoids

Retinoids also interchangeable with retinol, are vitamin A derivatives that can help speed up cell turnover, thus helping to reduce the appearance of hyperpigmentation. They also prevent excess melanin by inhibiting tyrosinase and are useful for reducing melasma and post-inflammatory hyperpigmentation. Fortunately, they also help boost collagen production for ant-aging effects.

Azelaic Acid

Azelaic acid is an organic acid found in grains, like barley and rye. It has anti-inflammatory properties and can suppress melanin production in the skin. Azelaic acid is gentler than some other acids. It is a safe option during pregnancy, unlike retinoids.

AHAs and BHAs

Acids in general work as exfoliants to remove dead skin cells and ultimately increasing cell turnover. Increased newer and younger cells coming to the surface results in a brighter complexion, even skin tone, and fading of hyperpigmentation.

Sunscreen
And last but not least, sunscreen!! Sunscreen does not lighten hyperpigmentation but it prevents sun damage, helps fade it and keeps it from getting worse