Skin: Pigmentation – no seriously what is it actually?
Pigmentation – we’ve all heard of it – but do we really know what it is. There is more than one type of it, and there are many causes and prevention’s out in the market – it’s hard to know what truly works and what doesn’t. So we turned to Melanie Grant to get our questions answered – as the first official skin expert for CHANEL Australia and the go to skin saviour to some of the nations dewiest faces – who else would we have turned to?
Melanie Grant is a renowned Australian skin professional. She specialises in tailored treatments designed to enhance an individual’s skin and complexion. This is done with state-of-the-art technology and therapeutic products and formulations used in tandem with prescriptive skin maintenance regimes.
In between finalising her soon to be launched Melbourne practice, we spoke with Melanie to get the lowdown on all things pigmentation…
Let’s cut to the chase… what really is pigmentation?
Skin pigmentation, or strictly speaking hyperpigmentation, is a condition where we have spots or patches of skin darker than surrounding areas of skin. This is usually harmless and caused by excess production of melanin within the skin.
There are different types of hyperpigmentation including melasma, chloasma, solar lentigines (liver spots,) ephelides (freckles,) post inflammatory hyperpigmentation and dark under eye circles.
Melasma is a skin condition which usually presents as brown patches across the forehead, upper lip, sides of the face and bridge of the nose. This condition usually effects adult women who are on the pill, or have an iud fitted. It worsens during summer when the skin is exposed to sun and heat. A small percentage of men can also suffer from melasma.
Chloasma, also known as the mask of pregnancy, is a hormonal change condition caused by overproduction of melanin during pregnancy. It will also worsen when exposed to sun and heat, however this condition usually resolves post pregnancy. It can appear in a mask like pattern across the forehead, nose, cheeks and upper lip.
Solar lentigines, also known as sun spots or liver spots, are simply caused by damage to the skin due to consistent overexposure to the sun. These appear as large or small dark spots on the skin. While most commonly found over the face, chest and back of hands, they can appear anywhere over the body.
Ephelides or freckles are usually hereditary, but can also be sun induced. They become larger and darker when exposed to the sun. We most usually see them sprayed across the nose and cheeks of fair children and younger skin.
Post inflammatory hyperpigmentation (PIH) occurs after trauma or injury to the skin. Most often seen as the small brown mark left after an acne spot has cleared or other skin lesions. So it’s really important to avoid squeezing your pimples to avoid this type of pigment. PIH can also occur from overly aggressive or inappropriate laser.
Dark circles under the eyes are usually a hereditary hyper pigmentation condition. They can also be caused by blood vessels appearing through the thin and delicate skin under the eyes.
So what are the main causes?
Living in Australia, the most common cause I see is sun induced hyperpigmentation. The biggest mistake is women thinking that their makeup offers sufficient sun protection – and it really doesn’t. We live in a harsh climate and we need to be absolute in our diligence with sun protection.
Another very common cause is hormone induced pigment as so many of us are on the pill, HRT or IVF.
What products can be used at home to reduce pigmentation?
Let’s start with prevention. The most important ingredient is a good quality broad spectrum sunscreen. You cannot successfully treat pigmentation without protecting your skin from the sun – so this is the most important ingredient of them all. Look for ingredients like niacinamide, vitamin c, retinol, kojic acid, azelaic acid and liquorice root to fade pigment. Aha’s such as glycolic acid and lactic acid encourage cell turnover, and brighten the skin. Prescription strength Hydroquinone (4%) is a very effective, however it’s often not well tolerated and shouldn’t be used for more than three months at a time.
I really like Cosmelan and Lytera (both products) for long term use at home to both lighten and prevent pigment.
What procedures can be used to reduce pigmentation?
I favour laser such as Fraxel to treat sun induced pigment. IPL is also very effective and has the added benefit of treating the diffuse redness that is also usually present on a sun damaged skin.
Fraxel may require three to five treatments depending on the severity of the pigment. The laser works by works by treating microscopic portions of the skin at a time (like pixels).The unwanted skin is damaged by the laser, triggering the bodies natural healing process. The unwanted damaged skin is shed and replaced fresh new skin.
IPL usually requires three to five treatments also. It works by passing a beam of light through the skin targeting and fragmenting the melanin in pigment. The melanin is then absorbed by the body, rendering them less visible.
For hormonal pigment I’m extremely cautious as treating this type of pigment with laser can actually make it worse. I prefer to treat melasma using a combination of chemical peels such as Dermamelan or Cosmelan with a course of LED light therapy.
These peels work by inhibiting the enzyme tyrosinase that is involved in the manufacture of melanin within the skin. In other words it helps to stop the excessive production of pigment. Lactic Acid peel dare also great as they help to resurface and Slough away unwanted skin gently. LED light therapy stimulates healthy new skin.
What can we all do to avoid pigmentation?
A preventative approach is always best. Sun induced pigment is prevented by staying out of the sun and wearing the appropriate sunscreen, hats and clothing. The Australian sun is particularly harsh so the spf in your makeup is not sufficient and the damage is incidental and accumulative, so things like driving to work or having lunch outside contributes to damage.
Hormonal pigment such as melasma would be avoided by not taking the pill or using HRT or IVF, however this is unrealistic so I would say to manage the condition with appropriate skincare and diligent sun protection.
Post inflammatory pigment can also be avoided by not squeezing pimples.
There’s increasing evidence that following an anti inflammatory diet ( avoiding dairy, wheat, soy, peanuts and refined sugars) will also help to manage the condition.