Skin Pigmentation or Melasma
The difference between freckles and problem pigmentation is: a) while facial freckles though appear quite cute, larger, darker pigmentation patches don’t; b) freckles generally go faint in winters and darken in summer due to exposure to sun; problem pigmentation however does not fade out like freckles, and can be a cause of distress.
You might have noticed these appearing as your skin ages, or if you have had a sun burn. These are common on the face, neck, arms and hands. Facial pigmentation generally occurs secondary to damage to the way the pigment cells in your skin work. This damage is commonly caused by Sun Exposure over time, but can also be caused by Sun Burns, and Hormones. One of the commonest causes is Melasma, common amongst women who have darker skin types, this condition generally triggered by pregnancy or conditions causing disruption of the normal hormone levels like consumption of the Contraceptive Pill. The other common cause of facial pigmentation is PIH or Post Inflammatory Hyper-Pigmentation. This can be brought about by flare-ups of Acne, Eczema or as a side effect of a Chemical Peel or Facial.
There are multiple causes of facial pigmentation, the commonest are sun exposure, sun burns, Melasma, PIH. At the bottom of all the pigmentation problems is a change in behaviour of the Melanocyte (the cell that makes the pigment in our skin). While in a normal skin type which can tan or is coloured, the pigment cell (melanocyte) can switch on and produce more pigment as a response to sun exposure, which is the process of putting on a Sun Tan, which reacts differently in pigmentation problems. Sun Burns, Excessive Sun Exposure, Hormones of Pregnancy, other Endocrine (Harmonal Problems), Chemical Injury (Chemical exposure or peels), Thermal Injury (Burns or Laser or IPL treatments), Mechanical Injury (Trauma, Abrasions, Microdermabrasion, Microneedling) can all cause a damage to the DNA of the pigment cell, causing it to produce pigment all the time, regardless of sun exposure. This damaged melanocyte therefore ends up creating a pigmentation patch.
Unfortunately, makeup with added SPF does not quite protect you in the same fashion as a Sun Screen with SPF 30 or more would.
While most pigmentation can be reduced or faded to a large extent, there might be some residual pigmentation left behind after treatment that needs you to continue with special skin care and skin protection routines. This limitation in pigment removal owes itself to the fact that all the treatments designed for pigmentation, reduce the amount of pigment present in the skin, but don’t generally inactivate or remove the damaged Pigment Cell.
There is no one best cream for pigmentation. While the strongest cream that can be used by doctors is Hydroquinone, other Brightening Serums and Creams containing, Mulberry extract, liquorice extract, glycolic acid, Arbutin, Kojic acid, Vitamin C, Niacinamide, Azelaic acid, or Vitamin A (retinol) can also be helpful under doctor’s prescription.
Melasma is a common condition amongst women of colour and is generally triggered by pregnancy, birth control pills or other hormonal medications. While it does fade with time and sun protection in some women, in most patients treatment is needed. The treatment generally is a combination of skin care routines and in clinic procedures such as Chemical Peels, TCA (Trichloroacetic peel).
Common types of hyperpigmentation are Freckles (Ephelides), Solar lentigines (Liver spots or sun spots), Melasma, Post-inflammatory hyperpigmentation.
While there are no potent home remedies for pigmentation, you can certainly prevent it by meticulous sun avoidance or sun protection. You can also observe what is causing a flare up of the pigmentation and stop the cause, such as discussing alternative contraceptive methods, if you think that your OC pill is causing worsening of the pigmentation.
You will have to be examined by our doctor to decide if Lasers are going to play any role in managing your pigmentation.
Please understand that there is no silver bullet for skin pigmentation as it is very difficult to remove the damaged pigment cells permanently. Most of the treatments for pigmentation are designed to either REMOVE THE EXISTING PIGMENTATION IN THE SKIN CELLS or to REDUCE THE PRODUCTION OF THE DAMAGED PIGMENT CELL. Very seldom with very Deep Chemical Peels or with Laser Resurfacing, a proportion of the damaged Pigment Cells will be removed.
Treatments that remove existing pigmentation range from Chemical Peels, Dermabrasion, CO2 Lasers, Erbium YAG lasers, Q Switched Lasers, Intense Pulse Light (IPL).
Treatments that reduce existing pigmentation start with regular and sincere use of Sun Screen and Sun Avoidance. Orally administered Tranexamic Acid (Cyklo-f, Cyklokapron, Menstralite, tablets) can temporarily lighten skin pigmentation in certain conditions. Topical applications of Hydroquinone, Kojic Acid, Arbutin, Bearberry, Liquorice, Vitamin C and other molecules will further lighten the pigment by reducing the production of the pigment by the damaged Melanocyte.
* All prices quoted apply to surgery done at World Class clinic in Mumbai, India and are subject to variation based on prevalent exchange rates.
The cost of a consultation ranges from £50 - £100. The cost of treatments varies with what is selected in your program.
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General Medical Council
Associations of Plastic Surgeons of India
The International Society of Aesthetic Plastic Surgery
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Disclaimer: The content on this website is purely generated for awareness and educating purposes only. This shall not be considered as a substitute for professional advice or prescription. Every individual and their case is different, so the results mentioned on the website may vary from person to person.