It’s the sunny season here in Australia and right before our very eyes it seems a new freckle or spot emerges on our skin. But what kind it is? How do we prevent it, treat it, or at least minimise it? And how do we distinguish it from something more sinister?
Pigmentation refers to changes in the melanin (pigment) of your skin, but there are different types and they do not all respond to the same treatments. It goes without saying that any brown or black discolouration that looks out of the ordinary should be checked by a dermatologist or skin cancer specialist. But correct diagnosis of the type of pigmentation you’re experiencing is also essential if you’re to benefit from treatment protocols.
Freckles
The most common type of pigmentation is ephelides, or freckles. These are flat circular light spots on the skin, about the size of the head of a nail, that develop after repeated exposure to sunlight, particularly if you have a fair complexion. They appear darker during the sunny months and fade in the winter. Heredity also influences freckling, as witnessed by the striking similarity in the total number of freckles on identical twins. Freckles are benign but they may sometimes be confused with more serious skin problems.
Solar lentigines
A lentigo (plural lentigines) is a non-cancerous, pigmented spot with a clearly defined edge. Lentigines may evolve slowly over years, or appear suddenly. They may occur anywhere on the body and vary in colour from light brown to black.
These spots are caused by UV sun exposure and the degree depends on how much UV light these melanin pigments are exposed to. These must be monitored as they may develop into skin cancer and melanoma. Annual checks with your dermatologist or skin specialist is essential.
Melasma
Melasma or Chloasma is pigmentation that is deeper in the skin’s dermis. It appears on the face as larger brown patches with a non-distinct border. This type of pigmentation is more common in women. Though causes are unknown, it is often linked to hormonal imbalances. The condition is made worse with UV exposure, overheating the blood, some medications, pregnancy and stress.
Post-inflammatory hyperpigmentation
This is a response to injury of the skin and can be the result of acne, burns, friction or overly aggressive clinical treatments such as chemical peels, dermabrasion, laser and IPL. This condition often resolves with time and generally responds well to topical products.
Poikiloderma of Civatte
Often people think what is solely pigmentation is actually a combination of pigmentation and redness (surface blood vessels). This skin condition is called Poikiloderma of Civatte (POC), which is the common weathering change that affects the skin on the front and sides of the neck and décolletage.
POC is very common in Australian women. There are many contributing factors including the hot climate, excessive sun exposure, genetics and hormonal factors. It occurs commonly on women who neglect to protect their neck and chest from sun exposure. While focus has always been placed on using sunblock on the face, remember that the neck, décolletage and hands also need to be protected.
Medical treatments for pigmentation
A dermatologist or cosmetic doctor can correctly diagnose and recommend clinical treatments such as laser, Photo Dynamic Therapy (PDT), Intense Pulsed Light (IPL), Light-Emitting Diode (LED) therapy, acid or enzyme peels, along with appropriate skincare.
If seeking any of these treatments without medical advice, it is important to find a clinic or salon with experienced practitioners who understand exactly which type of pigmentation they are treating. A good practitioner will first discuss your specific concerns and medical history, any medications you take and diagnose your Fitzpatrick skin type (this is a system used to determine how people will pigment or respond to sun exposure).
IPL and LED light therapy is effective on most people with specific skin conditions such as pigmentation, sunspots, broken capillaries, redness and uneven skin texture. It can also improve the overall tone and texture of the skin, as well as treating fine lines by creating a more plumped up appearance. A series of four to six treatments may be required for optimum results.
Also, the importance of cosmeceuticals can not be emphasised enough. Quality active skincare goes hand in hand with an in-clinic treatment plan and, of course, an SPF30-50 sunscreen that is suitable to use on the face, neck, hands and décolletage.
Home treatments for pigmentation
There are many excellent home care products and treatments to target pigmented lesions. Unfortunately, once you have sunspots you can’t fully remove them, but certain ingredients and products can help fade and control discolourations.
Vitamin A
Vitamin A is a fundamental component (nay, the most beneficial) to any skincare regimen (including the fight against pigmentation). Look for Vitamin A serums in the form of stabilised retinol. It’s been proven to help renew the skin’s collagen and elastin and reverse the signs of ageing from UV.
Vitamin B
Vitamin B is also hailed by skin professionals for its ability to rejuvenate and strengthen skin against a broad range of skin conditions such as dryness, pigmentation and excess sebum.
Vitamin C
Applied in the form of L-ascorbic acid, Vitamin C helps protect cells from UV free radical damage, assists in collagen production and also helps prevent tyrosinase enzymes in
your body from creating excessive amounts
of melanin.
Alpha hydroxy acids
AHAs include glycolic, lactic, tartaric and citric acids, and have also been shown to help with pigmentation irregularities. AHAs can create mild irritation, so 10 to 15 percent is usually the concentration used in products. Be sure to use sunscreen on top of AHA products as it makes skin more sun-sensitive.
