How to treat pigmentation

Written By Geraldine Schefermann

Dark spots or skin discolouration appearing on your face?  It could be sunspots, age spots, melasma - there are many types of hyperpigmentation.  Here’s what you can do about it.

How do I know if I have pigmentation?

If you’re worried about dark spots that have appeared on your face - it could be pigmentation.  (Skin experts call it hyperpigmentation.)  

It happens when melanin—the pigment responsible for the colour of our skin —is deposited in the skin in greater than usual amounts, causing a change in the skin’s colour.

It can add 10 years to a person’s perceived age but happily, our treatments for pigmentation are getting better and better. More on your options for that below. 

I have personal experience of struggling with stubborn pigmentation.  I have spent the last 20 years getting my skin to where it is today and it is something I continuously address. Consistency pays off though! My skin has improved dramatically.

Common types of pigmentation I see in my clinic

Melasma - these are dark spots that often look like patches.  They appear on the forehead, cheeks and upper lip.  Melasma is mainly caused by hormonal changes, like those that take place during pregnancy, from birth control, or certain menopause medications.  It’s much more common in women than men and it’s more likely to develop in those with medium to dark skin tones.  Sunscreen every day is essential (my clients hear this from me a LOT) because UV exposure makes melasma worse.

Sunspots - this is the most common type of hyperpigmentation I see in my clinic.  Sunspots are caused from excess UV exposure over time.  Generally, they appear as spots on areas exposed to the sun, like the hands, neck, chest and face.

Post Inflammatory Hyperpigmentation (PIH) - PIH is the result of inflammation or injury to the skin. (Think of the discolouration left behind after a breakout, for example.)  As a protective response, the body lays down more melanin.  It happens with acne, deep cuts or burns.  Depending on your skin tone and ethnicity, PIH can appear as pink, red, purple, brown or black.

UV exposure is a huge factor in pigmentation.  When we’re exposed to UV, our melanocytes mount an inflammatory response, and produce more melanin as a protection measure.  More melanin, more pigmentation.  Even heat alone can increase pigmentation. 

The mighty melanocyte

Melanocytes are the cells that make melanin.  Think of them as microscopic, pigment-making factories.  Melanocytes have all sorts of receptors on their surface - the body sends certain signals, the melanocyte factories kick into gear. 

Like, when you’re stressed, the body releases cortisol.  This triggers the body’s repair and protection response (inflammation).  It also switches on the hormone that tells the melanocytes to start making melanin.  More melanin, more pigmentation.  A common area for stress pigmentation is the eyebrows.  

Other types of inflammation can cause pigmentation.  Injuries, spots, acne, eczema or psoriasis.  These stimulate the release of an enzyme called tyrosinase, which is involved in the first step of melanin production.  More tyrosinase, more melanin, more pigmentation.  

A lot of people don’t know that sex hormones (and certain types of birth control) can influence pigmentation.  Oestrogen can stimulate melanocytes to produce melanin, progesterone can tell melanocytes to dial production down.  Through all stages of life.  

Like in menopause, the melanocyte cell becomes less active and therefore we have much less protection in our skin as we age against UV, viruses and bacterial infections.  This can result in light and dark areas of pigmentation on the face. 

Polycystic ovarian syndrome can also result in hyperpigmentation, due to an imbalance in insulin levels. 

How do professionals treat pigmentation?

In my clinic, one of the advanced treatments I offer for pigmentation is Melanopro - the results are, frankly, impressive.  It’s a 2-phased clinical strength peel programme which has been proven to dramatically improve skin tone and texture.  We use it to treat melasma, sun spots, acne scars, dull skin and rough skin texture.  It fades all forms of pigmentation in under 6 weeks, with minimal downtime.  

It’s been extensively tested and is safe on all skin tones and ethnicities.  

The 6 week programme includes an in-clinic peel and an at-home treatment kit.  

  • Phase 1 starts with an Intensive Peeling Masque on Day 1.  I apply this in the clinic.  Two to seven hours later, the masque is removed by the client at home.

  • Phase 2 takes place at home - you’ll be given a kit that includes the Resurfacing Moisturiser with all the lovely actives that get things going.  It will last you 4-6 weeks and must be applied 2-3 times daily to stimulate continuous exfoliation, brighten skin, smooth texture and reduce the appearance of hyperpigmentation.

It’s different for everyone - but here’s what you can expect across the 6 weeks:

  • Day 1-6 flaking (plan for some downtime during this week, trust me though, it’s worth it!)

  • Day 7-15 adjustment

  • Day 16-48 results peak

Other ways to tackle pigmentation

No method can guarantee full removal of pigmentation because it can be deep seated in the dermis and because of all the internal factors involved. 

Melanopro is a very strong treatment and only certain clients are suitable for it. It can be done up to twice a year. However, chemical peels and microneedling can be done multiple times a year and are excellent ways to tackle pigmentation and ageing in general.  I tailor my treatments to my client’s skin and the concern we’re trying to address. All of my  treatments include skin resurfacing to some degree, and infusion of actives which help with skin tone and skin texture.  

And remember …

Patience is important.  It takes time to get underneath years of sun damage, hormonal patches or the deep scarring that can be caused by acne.

Safety is even more important.  I cannot stress this enough.  Only a highly qualified, trained and experienced practitioner should be using the clinical strength peels and lasers that are indicated to treat hyperpigmentation.  

SPF is a non-negotiable, 365 days a year.

Helping my clients achieve beautiful, glowing skin and the confidence that comes with that is so rewarding! For Melanopro, and my full treatment menu, please visit my booking page.

Sources:

Geraldine Schefermann
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