Pigmentation - Beauty Spot it's not so beautiful after all

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Hyperpigmentation (Darker changes to the skin)

Hyperpigmentation it almost creeps up on you. From a vague shadow to a noticeable skin discolouration almost overnight. The truth is in most cases the damage had been done years ago and has only recently surfaced, for others it’s due to skin trauma such as surgery, from skin conditions such as acne vulgaris and for the rest it may be medically or hormonally related. No matter the cause it seems as though scores of us suffer from hyperpigmentation at some point in our life’s and it most cases it can seem like an ongoing battle. Hyperpigmentation does not discriminate we are all at risk though people with darker Asian, Mediterranean or African skin tones are more prone to hyperpigmentation.


What is hyperpigmentation?

Melanin is a class of pigment produced by special cells called melanocytes and is responsible for producing and determining the colour of our skin, eyes and hair. When these cells begin to produce excessive amounts of melanin, pigment deposits/clusters occur beneath the skin and the result is hyperpigmentation. Hyperpigmentation can be scattered or focal and can affect any part of the body though is most common on the face, arms, chest, upper back and the back of the hands. Melanin is produced by melanocytes at the lower layer of the epidermis. With age our melanocyte cells become more erratic and are less controlled by the body this interferes with the melanin distribution especially when exposed to its enemies such as the sun.


What causes hyperpigmentation?

As mention over production of melanin results in hyperpigmentation, though there are many factors that cause and contribute to this overproduction. These factors are excessive sun exposure including solariums, hormonal changes, genetic factors, drug/medication reaction, and skin trauma such as surgery and inflamed acne and then there are birthmarks and moles.


The Different types and causes of hyperpigmentation


Sun Damage (including solariums)


In addition to giving of skin, hair and eyes its colour, melanocytes also play the role of our skins natural sun protection. When exposed to UV light our melanocytes are stimulated producing excess amounts of melanin trying to protect us from the sun unfortunately clusters of pigment can form and the result is sun damage in the form of sun spots, liver spots, and freckles and in more severe cases melanoma. This same process is what gives us a tan hence the popular ad “there’s no such thing as a healthy tan”


Melasma, also known as chloasma


Melasma/chloasma are generally cause by hormone fluctuations which cause melanocytes to become overactive and are characterised by brown patches on the face generally the cheeks, nose, forehead and upper lip. Both sides of the face are usually affected with the marks almost possessing a mirror image appearance. The most common sites of involvement are the cheeks, bridge of nose, forehead, and upper lip. Melasma predominantly occurs in women who are pregnant and is often referred to as “the mask of pregnancy” or who may be taking birth control pills. Melasma is made worse by sun exposure.


PIH or post inflammatory hyperpigmentation


This type of pigmentation usually occurs after some type of skin trauma such as inflamed acne, deep cuts or open wounds, and surgery. Other causes of PIH are incorrect or overly aggressive laser treatments as well as over use or incorrect use of some skin products and treatments containing excessive concentrates of chemicals such as salicylic acid, bleomycin, and cisplatin.


Linea nigra

a hyperpigmented line found on the abdomen during pregnancy.


Smoker's melanosis

pigmentation of the oral mucosa (mucus membanes of the tongue)


Haemochromatosis

A common but debilitating genetic disorder characterized by the chronic accumulation of iron in the body.


Treatment

To begin to treat hyperpigmentation and initial skin analysis consultation is a must in order to help identify the type and cause of the pigmentation through visual analysis and relevant medical history. When treating hyper pigmentation it is important to remain realistic and patient as results vary depending on the method/s chosen and the type of pigmentation being treated.


Topical methods include the use of hydroquinone, kojic acid, alpha hydroxy acids, azelaic acid, ascorbic acid, tretinoin (Retinol), topical glucocorticoids, and liquorice extract. A specifically tailed home skincare regime is a must to both treat and prevent hyperpigmentation, your therapist will recommend the best products for your particular case.


Apart from creams and lotions, hyperpigmentation can also be treated by utilising professional in clinic skin treatments such as chemical peels, microdermabrasion, and LED light therapy. Medical lasers are particularly effective in treating certain types of hyperpigmentation, such lasers Q Switched ND lasers and Fractional Laser.


Other treatment recommendations include
· Drinking 6-8 glasses of water to help flush out toxins

· Keep a check on tea/coffee and caffeine intake to a minimum

· Drinking coconut water daily is said to help fight hyperpigmentation.

· Introduce antioxidant supplements into your diet particularly Vitamin.C and Vitamin.B complex

· Apply a homemade mask consisting of yoghurt, lemon juice, tamarind paste, papaya pulp and pineapple juice. It helps to lighten and brighten the skins complexion.


Remember prevention is key and better than any treatment or said cure. So before its too late start protecting your skin today. Apply sunscreen of SPF 30+ daily 15 minutes before sun exposure, this is the key in preventing and minimizing not only the formation of brown spots but also the worsening of existing hyperpigmentation. It is recommended to wash and reapply your sunscreen every 2-3 hours to maintain maximum protection. The reality is that all treatments are void if the affected area is exposed to the sun without adequate UVA/UVB protection.


Hypogigmentation (lighter changes to the skin)


What is Hypopigmentation?

Hypopigmentation is the exact opposite of hyperpigmentation. Hypopigmentation is the result of underactive melanocyte cells resulting in a reduction in melanin production. This causes patches of skin to become lighter in colour than the surrounding skin. Hypopigmentation is not as common as hyperpigmentation.


What causes Hypopigmentation?


The most common causes/types of hypopigmentation are sun damage, skin trauma, vitiligo and albinism.


Sun damage


As mentioned when we are exposed to the sun our melanocyte cells begin to produce excess amounts of melanin this can in some cases shock or over work our melanocytes and they shut down slowing down the melanin production or ceasing all together resulting in lighter patches of skin


Skin Trauma


Skin infections, blisters, burns, or other trauma to your skin, might cause loss of pigmentation, in the affected area. However the good news here is that this type of hypopigmentation is usually temporary though it may take a long time for the area to re-pigment.


Vitiligo


Is an autoimmune disorder and is categorised by small and large smooth, white patches on the skin. These patches can occur anywhere on the body. In suffers of Vitiligo the pigment-producing cells are damaged hence no pigment production. Unfortunately there is no cure for vitiligo, however there are many cover up options that make the condition almost invisible.


Albinism


is an inherited disorder caused by the complete absence of melanocyte cells resulting in a complete lack of pigmentation in skin, hair, or eyes. People with albinism have an abnormal gene that restricts the body from producing melanin. There is no cure for albinism. People with albinism must use a sunscreen at all times.

So remember it’s easy to think that spending the weekend sunbathing is doing no harm because when you look in the mirror your skin seems to be holding up, unfortunately it’s the damage you can’t see that’s going to come back and haunt you in your older years. It’s then that you are going to wish you’d been wiser in your youth and listened to those slip, slop, slap ads. It’s never too late to start. Take care of your skin it’s the only one your ever gonna have.