Pigmentation and Uneven skin tone
An all too common skin condition
Harsh environmental conditions in Australia and New Zealand make us susceptible to pigmentation or freckling, and these little spots can often be the start of more serious skin conditions. In this section we take a look at the various types of pigmentation, from hereditary conditions, birthmarks, to trauma and sun damage.
The colour of your skin is determined by the level of melanin (or pigment) in the skin. It ‘colours’ your skin, hair and the iris of the eyes. Your level of melanin depends on race and exposure to sunlight. Production increases with exposure to the sun as it attempts to protect the skin against harmful ultraviolet rays. Both women and men can have skin pigmentation problems relating to hormone changes and sun exposure. Pigmentation is really a chain reaction in response to damage being inflicted to our skin.
Signs and Symptoms
Distinguishing between hypo pigmentation (loss of pigment) and hyper pigmentation (increase in pigment), is crucial to diagnosing the treatment. Hypo pigmentation is a decrease in the level of pigmentation of the skin, whereas depigmentation is a total loss of skin pigment. Both can be either concentrated in one area or generalised.
Hyperpigmentation is stimulated and caused by UVR (sun), inflamed, or other skin injuries, including those related to acne vulgaris. People with darker Asian, Mediterranean or African skin tones are also more prone to hyperpigmentation, especially if they have excess sun exposure.
Many forms of hyperpigmentation are caused by an excess production of melanin. Hyperpigmentation can be diffused or local, affecting such areas as the face and back of the hands. Melanin is produced by melanocytes at the lower layer of the epidermis. Melanin is a class of pigment responsible for producing colour in the body in places such as the eyes, skin, and hair. As the body ages, melanocyte activity, and where concentrations of the cells are denser than surrounding areas, hyperpigmentation is affected. Hyperpigmentation can also be caused by using poorly formulated topical creams.
Types of pigmentation
- Presents as brown patches on the face of adults and some adolescents. Most commonly affected areas are the cheeks, bridge of nose, forehead, and upper lip. Usually occurring in women, it affects only 10% of men. Often women who take contraceptive pills or have an IUD fitted develop this type of pigmentation.
- It can become more prominent if the skin is exposed to sunlight; hence often worsens during summer.
Some pregnant women overproduce melanin and develop this condition often referred to as the ‘mask of pregnancy’. Chloasma can cover a relatively large area of the face and even abdomen and may worsen after sun exposure.
- Also called sun, age, or liver spots, these are benign flat brown spots that look like large brown freckles. They appear on sun exposed skin, such as the face and back of the hands
- 90% of fair skinned people over the age of 60 develop this condition. In general, those who are most likely to have solar lentigines are people who have a tendency to sunburn and tan a little or not at all (skin Fitzpatrick Types 1 and 2)
- Freckles are also common and usually a hereditary skin blemish. Though freckles are often thought of as attractive, some people seek treatment to reduce them.
- Vitiligo is another form of hypo pigmentation caused by the loss of pigment-producing cells in the skin (melanocytes) for which there is no current cure.
- These white patches are extremely sensitive to the sun. Affecting nearly 2% of the population, it is most prevalent amongst those with darker skin and typically strikes those as young as 10 through to approximately 30 years of age.
- Whilst the exact cause is unknown, some scientists believe Vitiligo may be caused by an autoimmune disorder. It is also linked to hyperthyroidism and Addison’s disease that affects the adrenal glands.
- As expected, this type of abnormal skin discolouration will appear at birth or shortly following. Most are non-cancerous, though a doctor should examine your child if born with abnormally coloured skin or develops birthmarks shortly after birth.
- Types of birthmarks include Haemangioma, Port-wine stains, Macular stains and pigmented birth marks.
Post Inflammatory Hyper Pigmentation (PHI)
- PHI (post inflammatory hyper pigmentation) usually occurs after an injury to the skin. It can commonly occur after acne spots or other skin lesions, after traumatic skin treatments, such as inappropriate or overly aggressive laser or after over use of some skin care products-particularly those that have been mis-diagnosed for the skin type.
Aggravating Factors of Pigmentation
- UV exposure
- Immunological conditions
- Genetic predisposition
- Perfumes and essential oils in conjunction with UV exposure-particularly Bergamot
- Fruit acid or chemical peels in conjunction with UV exposure
- Incorrect use of IPL and Lasers
- Some medications including the contraceptive pill
- Hormonal fluctuations such as menopause
- Free radicals
- Pigmentation post acne
- Trauma to the skin (post inflammatory pigmentation)
- Vitamins A, C and D deficiency
Correct skin care and treatments to help manage symptoms
Pigmentation can be very difficult to treat effectively as the causes can be from so many different underlying reasons. While pigmentation often can be prevented simply by avoiding UV exposure, sometimes it cannot be avoided. Cellular health is very important to improving the condition and a dietary intake of essential fatty acids such as Omega 3 & 6 is beneficial. Protection from UV exposure is of the utmost importance.
Pigmentation changes that are visible of can be treated with the use of dermaviduals Whitening Concentrate, Vitamin C Liposomes, Liposome Concentrate Plus (azelaic acid inhibits melanin synthesis and is effective against hyper pigmentation and melisma) Vitamin A Nanoparticles, Vitamin B Complex and CM Glucan.
Whitening Concentrate: extracts inhibit tryosinase and the formation of melanin. Liposomal encapsulation increases its efficacy and is suitable for long term use.
Vitamin A: supports collagen formation and promotes the regeneration of the skin. Recommended for the treatment of prematurely aged skin affected by UV damage.
Vitamin C: free esters of the Vitamin C are released by enzymes and support the formation of collagen. Recommended for use before and after laser treatments to prevent the formation of melanin deposits.
CM Glucan: provides excellent skin protection and is recommended for skin barrier disorders. Accelerates skin healing and protects skin against bacterial infection. CM Glucan can be used for sensitive skin, before and after sun exposure and offers and element of photo protection against UV-radiation. Recommended after chemical peeling & post laser treatments.
Vitamin B Complex: stabilises cell membrane and assists in the integrity of the lipid bi-layers. Vitamin B3 encourages even skin tone and texture whilst improving elasticity at the same time. Niacinamide enhances the function of the skin barrier by increasing ceramide and free fatty acid levels.
It is particularly important to visit a qualified dermaviduals clinician to seek a full skin consultation prior to commencing any tailored home care or clinical treatment program, as the cause of pigmentation and the effect of these ingredients means a variety of treatment options are available.
Collagen Induction Therapy and pigmentation
If pigmentation is a concern for you, the use of dermaviduals in conjunction with Collagen Induction Therapy may be your solution. It is very important to do this under professional guidance. https://www.dermaviduals.com.au/salon-finder.html
NOTE: A mechanical peeling is NOT always recommended for pigmentation nor is Laser or IPL as standalone treatments. You will achieve better results with pigmentation utilising a combination of different modalities (including CIT, LED or IPL) and dermaviduals. (concept skincare skin of young woman before and after)
Corneotherapy and pigmentation
Repairing the skin barrier. It is very important to restore the skin barrier function and in doing so, repairing the bilayers of the stratum corneum before commencing any treatment protocol for pigmentation. This procedure of bringing the skin into homeostasis has become known as corneotherapy and uses base creams with a structure similar to the bilayers of the skin. Appropriate moisturising substances are amino acids, which are also contained in the NMF (natural moisturising factors) of the skin. Corneotherapy is the perfect precondition to support the healing process in the deeper layers of the skin. In this regard, the well- known dermatologist professor A. Kligman has coined the term ‘outside-in’ therapy, to which dermaviduals subscribes. Disorders of the barrier function are caused by intense UV radiation. Imagine a car parked in an outside car park all day in summer-the same scorching heat on the car is also evident on the skin. Hence protection is vital.
Echinacea: relief against sunburn. Whenever the individual’s threshold of sun tolerance is exceeded, the UV radiation from the sun causes erythema (redness). Symptoms range from minor reddening to distinct sunburn. There are several skin care therapies which have proved successful such as Echinacea extract and D-panthenol, which both quickly show positive results in this regard. The combination with a liposomal concentrate has synergetic effects as the phosphatidycholine acts in an anti-inflammatory capacity due to the high dosage of gamma linoleic acid. The application of Aloe Vera protects the skin and provides cooling effects. As skin displaying erythema (redness) is extremely permeable and the skin barrier is compromised, preservatives and perfumes are not recommended for those with sensitive skin.
Permanent protection. Protect photo-damaged skin in the long run in order to avoid accumulated damage. This does not necessarily mean permanent use of sunscreen. The skin requires a small amount of UV light to produce vitamin D3. However, it is very important that the cells are safely protected. The unique dermaviduals delivery system enables this to occur. Phosphatidylcholine has proved successful as mentioned above in bringing an element of natural sun protection. Combinations with amino acids (Natural Moisturising Factor) with the potential to scavenge reactive oxygen-containing radicals and peroxides, and CM Glucan which is a natural polysaccharide derived with DNA protective function, do not strain the skin and are free of allergenic and irritating substances. Utilising these ingredients in base creams will provide a level of cellular protection against UV damage, and a sunscreen should be applied for UVA and UVB protection.
Vitamin C with a double function. The skin elasticity is impaired by UV radiation as well as by IR radiation activated collagenases and metalloproteinase. Liposomal Vitamin C derivatives may activate the collagen forming enzymes by permeating the vitamin C derivatives into the skin where they are hydrolyzed by enzyme reactions. In this regard applied vitamin C has a lightening effect so the skin produces less melanin to protect against UV radiation. Thus Vitamin C liposomes may also be used in case of hyper pigmentation. Similar effects have liposomal encapsulated vegetable extract of mallow, mint, cowslip, lady’s mantle, veronica, balm and yarrow that are utilised in dermaviduals whitening serum. These plants are reported to inhibit tyrosinase which is responsible for melanin synthesis. As tyrosinase inhibitors may only be used on a preventative base, already formed pigmentation takes some time to show a lightening effect. Peelings may increase the effects as they remove part of the already formed melanin; however caution needs to be taken with the nature of the peel as these in itself are often a contributing factor.
Skin care concepts. In addition to the protection against further sun damaged, it is important to focus on long term care for pigmented skin. Experience shows that in addition to the above mentioned corneotherapeutic measure the application of liposomes and nanoparticles proves successful as they repair skin problems which are induced by disorders of the ceramide group. They interfere with the ceramide sphingomyelin balance, reactivate the exchange of substances between the different skin layers and catalyse the natural regenerative potential of skin.
For further reading:
- Dr Hans. Lautenschlaeger, various publications beauty forum & cosmetic medicine
- Dr Lance Setterfield