Let’s Talk: Skin Pigmentation

What is pigmentation?

Pigmentation refers to skin colouring due to melanin synthesis and deposition in the epidermis. Melanocytes are the pigment-producing cells responsible for determining skin colour. Lightening or darkening of the skin depends on melanin synthesis and the amount distributed. Intrinsic and extrinsic factors contribute to the formation of hyperpigmentation and hypopigmentation. To effectively treat pigmentation, it is important to determine the cause and type of pigment present.

What causes pigmentation?

There are several causes and influencing factors that contribute to the formation of hyper/hypopigmentation so we will discuss both internal and external factors.

Intrinsic

• DNA/genetics e.g. Vitiligo (depigmenting disorder) and Addison’s disease
  • Nationality- determines skin type (darker skin types are more susceptible to dyschromia and post-inflammatory hyperpigmentation)
• Hormonal changes e.g. pregnancy is an underlying cause of melasma
• Inflammation

Extrinsic

• Sun exposure (UVR)
• Weather/climate
• Pollution
• Drug-induced skin pigmentation

What are the different types of pigmentation?

• Freckles
  • Small, brown, flat lesions
  • Common in youth (lighten with age)
  • Causative factors: Genetics and sun exposure
• Solar lentigines
  • Sun-induced brown, flat lesions
  • Causative factors: Chronic sun exposure
• Melasma
  • Brown, flat pigmentation that is symmetrical (“butterfly pattern”)
  • Causative factors: Sun exposure, hormonal changes, pregnancy and the contraceptive pill
• Poikiloderma of Civette
  • A combination of mottled pigmentation and telangiectasia (upper chest in a V-shape and sides of neck)
  • Causative factors: Hormonal factors e.g. menopause, genetics and chronic sun exposure
• Post Inflammatory Hyper Pigmentation (PIHP)
  • More common in skin types III and above
  • Exacerbated by sun exposure
  • Causative factors: Occurs as a result of trauma to the basal layer followed by inflammation e.g. laser
• Actinic bronzing
  • Areas of sun exposure remain darker (or tanned) despite seasonal variations
  • Causative factors: Chronic sun exposure

How can we effectively treat pigmentation?

Pigmentation can be stubborn so it is important that the cause is known prior to treating so that the incidence of recurrence can be reduced. When deciding on home skin care, cosmeceuticals are essential when treating pigmentation, as they will ensure enhanced penetration into the skin to cause effect. Skin lightening agents and tyrosinase inhibitors can effectively lighten and reduce hyperpigmentation. Tyrosinase inhibitors work by blocking or sedating the production of melanin in the skin, which is produced from tyrosine, an amino acid involved in the biosynthesis of melanin AKA pigment. The goal when using cosmeceuticals is to brighten, lighten and even your skin tone. Dermal therapies such as laser and chemical peels in conjunction with cosmeceuticals will ensure quicker, more effective results.

A broad spectrum SPF is the most valuable skin care tool, as it will prevent sun-induced pigmentation from even occurring. SPF is anti-ageing and should be used at any age when the skin is going to be exposed to direct sun light.

Note: Treating most types of pigmentation requires ongoing maintenance. Listen to your treating practitioner and ensure compliance with post treatment recommendations and cosmeceutical use.

Medik8 and La Clinica recommendations

Tyrosinase-inhibiting ingredients include ascorbic acid (vitamin C) and Alpha Hydroxy Acids (AHAs). Retinoids are also extremely effective in treating pigmentation. Many botanical extracts such as licorice, bearberry, kojic acid, niacinamide and white willow bark, to name a few, also have the potential to lighten pigment and are commonly used in cosmeceuticals. Not only will you lighten pigment with products containing these ingredients, you will also achieve that youthful glow.

La Clinica

An effective skin care regime doesn’t have to be difficult. La Clinica have made it easy and affordable for you by putting everything you need to lighten and brighten your skin all in the one kit! Pair the “White Brilliant” kit for pigmentation correction with La Clinica’s SPF 50 and all your skin care needs will be met to combat pigmentation effectively.

The White Brilliant kit contains a cleanser, serum, moisturiser and mask. La Clinica use enhanced penetration technology to ensure that all the ingredients in the products reach their desired target to cause effect and ensure results. The kit aims to inhibit the production of tyrosinase that results in the over-production of pigmentation, providing skin rejuvenating, hydrating and anti-oxidant benefits for the skin. This unique complex not only assists in lightening pigmentation but also brightens the skin. Leaving the skin feeling smoother and fresher due to its ability to promote the exfoliating of dead skin cells and new cell renewal.

Medik8

Medik8’s powerful pigmentation range provided results in as little as 2 weeks! The products are free of retinoids and hydroquinone so are suitable for sensitive skin.

Brightening powder cleanse- resurfaces, illuminates and combats all types of pigmentation concerns. This dual-action powder-to-foam cleanser formula combines both physical and chemical exfoliants to buff away stubborn pigment from the upper layers of the skin. The main ingredient, oxyresveratrol (Oxy-R found in mulberry plants), inhibits the enzyme responsible for melanin production, revealing a radiant, more even complexion.

White balance brightening serum- this serum combines the brightening power of both Oxy-R and vitamin C at high strengths for the ultimate luminous complexion. It contains 20% ethylated L-ascorbic acid, a stable and potent form of vitamin C, that works as an antioxidant to protect the skin from harmful UV rays and free radicals, whilst also blocking the pathways to pigment formation in the skin. Turmeric root extract is another ingredient in this product that helps inhibit pigment production, whilst providing antioxidant protection against free radicals.

White balance everyday protect- A lightweight moisturiser with sunscreen to protect skin from harmful UVA/UVB rays, plus anti-pigmentation actives to deliver unbeatable brightening and anti-ageing benefits. This product provides luminosity thanks to light-reflecting pigments and all-day hydration.

White balance overnight repair- repairs and restores skin whilst you sleep. It also contains oxy-R, gluconolactone and liquorice and mulberry extracts to reveal a brighter and clearer complexion. The soothing niacinamide ingredient tackles the issue of pigmentation caused by inflammation and inhibits the movement of melanin into skin cells.

In-clinic treatments

We have the gold standard of laser (Picoway) that is used for pigment and rejuvenation treatments. It is a true picosecond laser that can be used with 3 different wavelengths and can treat ALL skin types.

Pigment Specific Spot Treatment

After an initial skin check by a medical practitioner to deem it a safe area to treat with the laser, your problem pigment type can be assessed.

Once the cause of the pigment issue you would like treated is known, we can assess what parameters to use to best treat the area. The treatment in clinic is quick. The areas treated will often initially whiten but by the time you leave the clinic the areas have usually darkened. The areas treated may sometimes become crusty before this comes away naturally over a period of approx 2 weeks, leaving lightened and new skin behind. It is important not to pick at the areas. Sometimes subsequent treatments are required depending on a variety of factors including what caused the pigment issue, how long it’s been present etc.

You may be prescribed products to use by your clinician to use for a period of time pre treatment and/or post treatment. This is to prepare your skin so your results are optimised and to give you the best possible end result

Resolve Skin Rejuvenation

This very popular treatment involves a series of passes over the entire area treated (eg face, neck, décolletage etc) using different wavelengths and settings. Very specific hand pieces are also used. This is designed to cause Laser Induced Optical Breakdowns (LIOB’s) at different depths under the skin to encourage and stimulate collagen and elastin growth over a period of 4 weeks. This can be done as a singular treatment but best results can be noted after a series of 6 at 4 weeks apart. There is no downtime apart from some initial redness and a feeling of having a light sunburn. This can last up to approx 24 hours in some but makeup can be worn to cover if necessary.

You will get a specific prescription from your clinician for how to treat the area with products at home following treatment. Once again, this is to provide you with the best results possible for your skin.

The area will be more photosensitive afterwards, so the use of a high SPF cream is imperative.

Before any laser treatment it may be appropriate to cease any products you are using on the area that contain any active ingredients (eg vitamin A or retinol).

Read more about In Clinic Treatments

Post treatment-care against the sun– compliance is absolutely necessary to ensure results

• SPF, SPF, SPF and re-application when necessary
• Wear a broad-rimmed hat when outside in direct sun light
• Wear protective clothing when in direct sun light
• Wear gloves when driving
• Avoid direct sun light when not adequately protected