Sun Awareness Month How To Prevent & Treat Pigmentation

Does Sun Exposure Cause Pigmentation?
Over exposure to sun damages the skin, which can cause discolouration, dark skin patches and uneven skin tone, known as pigmentation. Signs of premature aging includes fine lines, wrinkles and loss of flaccidity. Over exposure to the sun can lead to skin cancer, as explained in the article ‘Sun Awareness Month – Skin Cancer Awareness’.

In this article I will explain what pigmentation is, the causes, the different types, how to prevent it developing, and how to treat existing pigmentation.

What Is Pigmentation?
Pigmentation is characterised by certain areas of the skin that have become darker than the rest of the surrounding area. Pigmentation can appear in many diverse shapes and sizes, typically on areas of exposed skin surfaces such as the face, chest, and the backs of hands, in some cases even the body.

Pigmentation develops when the skin produces more melanin than usual in a specific area.

Melanocytes are skin cells in the deepest layer of the epidermis. These cells produce the pigment known as melanin. Melanin steadily works to the surface of the skin to give an individual their unique natural skin colour. This is a natural photo-protection process against sun exposure.

Sun Exposure, along with other triggering factors, causes the melanocytes to over stimulate, become hyper active, thus producing excess pigment known as hyperpigmentation.

Chronic hyperpigmentation can cause a reversal affect, where the pigment (melanin) moves down into the dermal layer. This pigmentation is known as ‘melasma’.

How Is Pigment Produced In The Skin?
Melanogenesis is the natural formation of melanin that is happening continuously in our skin, producing the individual’s natural skin colour.

The process of melanin synthesis and distribution is known as melanogenesis. A chemical action takes place with the copper iron, cu2, and the tyrosinase enzyme. As these two components connect an activation takes place, oxidising four times to produce amino acids Tirosine, DOPA, Dopaquinone and Melanin.                     

When we are exposed to the negative triggers, they over stimulate the melanocytes as well contribute to more free radical damage. This will speed up the activation of the cu2 and the tyrosinase enzyme to produce melanin.

Triggering Factors 
All of the trigger factors listed below rely on sun exposure as the main triggering component in the development of pigmentation. Usually, two or more trigger factors will lead to characteristic dark spots.

Sun Exposure
Is the main trigger in the development of pigmentation, and makes all of the other triggers worse. It does not matter what type of pigmentation an individual has, sun exposure will always be the leading contributory trigger.

Genetics
Predominantly skin with freckles and a fairer skin tone, 1 to 2 on the Fitzpatrick phototype scale.

Hormonal Factors 
Hormonal factors can include puberty, menopause, pregnancy, and any other underlining hormonal problems such as endometriosis and poly cystic ovaries. Stress activates the production of stress hormones, such as cortisol, androgens and adrenocorticotropic. When an individual is undergoing hormone imbalances, combined with exposure to the sun, pigmentation can develop.

Certain Medications 
Certain medications are photosensitising, thus when combined with exposure to the sun, pigmentation can develop.

Passing Of Time
Individuals accumulate more sun exposure in the passing of time. As one matures it is more common for the skin to develop pigmentation, known as ‘senile lentigos’.

 Chemical Substances 
Some chemical substances may not be suitable for the skin, or react negatively when combined with exposure to the sun, thus pigmentation can develop.

Inflammation 
Inflammatory skin conditions such as acne, dermatitis, burns, a cosmetic laser treatment or chemical skin peel gone wrong. or any skin injury can be a contributing factor in the development of pigmentation when exposed to the sun.

When the skin undergoes an inflammatory response, or is in an inflammatory state and has not had time to heal, this combined with the exposure to the sun tends to lead to post inflammatory hyperpigmentation (PIH).

What Are The Different Types Of Pigmentation

The are four main types of pigmentation.

Melasma 
Tends to involve two or more triggers, plus sun exposure.

This usually appears in a symmetrical pattern, on cheeks, forehead, upper lip, and chin with undefined edges.

It is chronic hyperpigmentation, which is the hardest to treat.

Post Inflammatory Hyperpigmentation (PIH)
Triggers tend to involve photosensitised medications, and or inflammatory conditions, plus sun exposure. This can appear on any area of the face or body.

Age Spots – Senile Lentigos
Tends to be in individuals over the age of 50, with years of exposure to sun. However, age spots can develop in individuals as young as 30. These are known as solar lentigos.

Age spots can be made worse with continuous exposure to the sun or sun beds.

These can appear on the chest, back, on the backs of hands, and facial contours.

Ephelides – Freckles
These tend to be more prevalent in skin within a low phototype. Generally found on areas of the face, chest, back of hands, but can appear on all areas of the body.

Freckles are a type of sun damage where an individual may have a natural predisposition. People are not born with freckles. However, they can develop from a very young age in those who are natural predisposed to them, along with being exposed to the sun.

Freckles are made worse with the exposure to the sun.

Ochronosis
Ochronosis is an uncommon pigmentation disorder. It has clinical characteristics of blue, black, grey pigmentation hues. It can also feel rough, and some call it rhino skin. The main cause is linked to the abuse of the ingredient ‘hydroquinone’. It appears to be melasma, but it is definitely not. Crumbling of the cells along with other cellular damage makes this skin condition untreatable in an aesthetic environment and must be referred to a dermatologist.

How To Prevent Pigmentation
Top 3 tips:

1. Wear a high SPF daily
2. Cover Up – Wear a hat, etc
3. Apply anti-oxidant ingredients to the skin

Simply protect your skin from sun exposure at all times.
Understand the types of sun rays and how they can affect the skin.
Establish how to protect your skin.

Learn more – CLICK TO READ THE ARTICLE
‘Sun Awareness Month – How To Be Safe In The Sun’.

How To Treat Pigmentation
The aim of a depigmentation treatment program is to remove or reduce pigmentation and to provide tools to regulate the production of melanin.

Before initiating a depigmentation treatment program, first visit a highly experienced skin aesthetician or doctor for a personlised diagnosis. In order to achieve an effective depigmentation action, the professional will need to consider each individual’s skin type, the type of pigmentation, the depth of the pigment and the most appropriate treatment program procedure.

Expect the professional to use a skin scanner or a woods lamp tool to better diagnose the characteristics of the pigmentation. It is extremely important to ascertain the type of pigmentation to ensure the correct treatment is undertaken. 

Fire Triangle Treatment Analogy
A little imagination is required here; The fire triangle has 3 sides with the fire (the pigment) contained in the middle, by removing just one side of the triangle, the fire (the pigmentation) would escape into the skin.

What Is A Fire Triangle?
A fire triangle consists of 1. SPF’s & Antioxidants, 2. Tyrosinase Inhibitor Ingredients, 3. In Clinic Treatments:

SPF’s & Antioxidants
Both must be applied to the skin as instructed by the aesthetician, several times daily to protect against the stimulation of the melanin production.

Tyrosinase Inhibitor Ingredients
Tyrosinase inhibitors are ingredients found in the skincare treatment and home-care routine products with a specific action, to re-educate the melanocyte skin cells.

A tyrosinase inhibitor acts as a guard to block the connection between the cu2 and the tyrosinase enzyme, which stops the activation of melanogenesis. This allows the melanocyte to stop over producing, thus to be regulated.

It is a critical component of the reduction of pigmentation as it will slow down the production of melanin, prevent the pigmentation becoming worse or allowing new pigmentation to develop.

In clinic treatments
In clinic treatments are essential to the successful removal of the pigmentation. SPF and tyrosinase inhibitors do not remove pigmentation, they work to prevent the pigmentation getting any worse and stop new pigmentation being developed. They do not remove the pigmentation that’s already there.

In clinic treatments such as exfoliating treatments and chemical peels physically lift the pigmentation out from within the skin.

Micro-needling and active pharmaceutical grade ingredients work to break down the pigment within the skin.

How Long Does It Take To Remove Pigmentation?
To successfully remove pigmentation, it is imperative to adhere to all 3 steps of the fire triangle listed above for an average of 9 to 12 months as the Melanocyte’s clever memory can immediately restart the hyper active pigmentation process. 

Chemical Peels 9 month’s minimum
Micro needling 9 month’s minimum
Cosmelan 12 month’s minimum

What Are The Best De-Pigmentation Treatments?
We successfully treat all types of pigmentation using the following:

Cosmelan®
This non-aggressive professional aesthetic treatment is based on a dual corrective and regulating action at both the dermal and epidermal level. It is effective on all types of pigmentation spots, including melasma. It is suitable for all phototypes on the Fitzpatrick scale.

Chemical Skin Peels
A Chemical Peel is a highly effective – prompt exfoliating treatment based on applying various acids on the most superficial layers of the skin, known as the stratum corneum of dead skin cells.

Here is an effective option:

Mesopeel® Melanostop
This skin peel offers a combination of active ingredients, including azelaic, resorcinol, phytic, and tranexamic acids specifically designed, medium intensity, focal treatment against hyperpigmentation. It is suitable for all phototypes on the Fitzpatrick scale.

MPen Micro-needling
A Micro-needling, combined with pharmaceutical grade specific ingredients, is a highly effective treatment to diminish pigmentation. It is suitable for all phototypes on the Fitzpatrick scale.

Contact Angela, a senior aesthetician of 35+ years, for a consultation and skin analysis.

Contact Here

More Questions I Am often asked:

‘Why do I need to treat the entire area, and not just the actual dark spots?
It is imperative to treat the entire area as melanocytes are linked into each other. Thus, if one is being attacked, i.e. treated, it will push the pigment onto other melanocytes.

‘Why is my pigment coming back?
Initially upon treatment, the surface pigment can disappear. However, during treatment the deep dermal pigmentation works its way to the surface of the skin, which can have the appearance of the pigmentation returning during consecutive treatments.

Do I need to apply SPF every day?
One day of unprotected skin within a nine-month period can undo all the work achieved during the treatment program.

Why is it so important to apply SPF every two hours?
As explained above, the sun is the main trigger in the development of pigmentation and makes the other triggers worse. It does not matter what type of pigmentation an individual has, sun exposure will always be the leading contributory trigger.

Why do I need to apply SPF if I’m not going out?
Sun exposure is not the only source of visible light. Every time you look at your technical device, such as computer, television and mobile phone, you are exposing your skin the HEV Light, High Energy Visible light (blue light). It penetrates into the dermal layer of the skin, like UVA rays. Exposure to the skin causes hyperpigmentation and premature ageing.

Will my pigment go if just apply the home-care products?
No, as mentioned above, in clinic treatments are essential to the successful removal of the pigmentation. Home-care products do not remove pigmentation, they work to prevent the pigmentation getting any worse and stop new pigmentation being developed.

Is it necessary to use the home-care products if I’m having the treatments?
Yes, as mentioned above, Tyrosinase inhibitors and SPFs treatment and home-care products are essential to protect and re-educate the melanocyte skin cells.

I’m going on holiday, is it ok to stop for a while?
Absolutely not, you need to maintain all aspects of the treatment program for the advised length of time. The upmost care must be taken to avoid sun exposure to the treated area.

SOURCES
National Library Of Medicine (NIH)
Public Med Central
ncbi.nlm.nih.gov
Mesoestetic Professional Education

Contact Angela for a free chat about your skin concerns.

Contact: 07930661971

Author: Angela Taffinder the founder of Emporium Treatment Clinic. A practising Aesthetician for 35+ years, holistic and wellbeing advocate and yoga instructor.