Pigmentation (or Hyperpigmentation) refers to changes in the skin’s colour due to the overproduction of melanin (skin-protecting dark pigment) by melanocytes (pigment-producing cells). It commonly appears on the face, neck, shoulders, décolletage and the hands giving skin an uneven tone. Pigmentation affects all skin types and conditions, not just people with fair complexions but those with dark complexions as well.
Appropriate amounts of cellular melanin production are nature’s defensive mechanism that prevents skin cells from UV damage. Abnormal or excess melanin production occurs when melanocyte cells become damaged due to frequent and prolonged sun and UV exposure or tanning beds, which can aggravate not only pigmentation issues but also accelerate the ageing process while causing cell mutations.
There are 3 types of pigmentation:
Epidermal (superficial) – Known as Post-Inflammatory Hyper Pigmentation (PIHP), this type of discolouration is usually close to the skin’s surface. It is the skin’s natural healing response to inflammation from a wound, injury/trauma and UV-induced sun-exposure. This is commonly caused by:
- Age / Sun Spots: Also known as Liver Spots or Solar Lentigines, these are flat brown, black or grey spots most commonly found on sun-exposed areas of the skin. As they tend to group together, they present as dark areas of pigmentation usually uneven in shape and skin tone. These are commonly found in people over the age of 40 although most damage generally occurs in a person’s youth before the age of 18. This damage begins to surface in a person’s 30’s as age or sun spots. Lighter complexions are at greater risk of developing age spots, although darker complexions and people who tan easily are not immune from this condition.
- Acne: Also known as macules and appear like a flat area of discolouration which is darker than the surrounding skin. It can range in colour from pink to red, purple, brown, or black and can occur in all skin colours.
- Freckles: These are small brown spots which are often concentrated in areas that get UV or sun exposure, and mostly occur in fair skins but can also occur in dark skins.
- Post-Inflammatory Hypo Pigmentation: After the skin heals from an injury, inflammation or due to over-stimulation, patches of skin may appear lighter due to loss of skin colour where the melanocyte cells stop producing melanin. Other contributory factors to this condition include UV, stress, genetics, ordered immune system and exposure to certain industrial chemicals. This can occur in all skin colours.
Dermal (deep) – Includes ‘Hori’s nevus’ and ‘nevus of Ota’, which are usually found in the deeper dermal layers. It results from possible inflammation, hormonal imbalance and UV/sun stimulation.
Mixed Epidermal/Dermal – Found in both the epidermis and the dermis. Melasma appears as brown or grayish brown patches on the skin, is hormonal-induced, and exacerbates during pregnancy and with use of oral contraceptives. Note: We DO NOT recommend IPL Photo Rejuvenation for treating Melasma/Chloasma as this actually exacerbates the condition.
Other contributory factors include genetics, diet and nutrition, lifestyle, hormones, medications, environmental factors, pregnancy, injury/trauma and cellular age.
Each pigmentation type is treated with various treatment options as well as individual preference and caution. Depending on individual skin type and condition, pigmentation can be greatly reduced and in some cases may be eliminated. This will be assessed in your initial in-depth skin consultation which will address your areas of concern with an appropriate treatment plan to achieve the best outcome.
Scroll down for suitable treatment options.