Loading

• Natural Image OC Member

• 

• View the Natural Image OC
       Patient Photo Gallery

pigmentation and brown spots

Hyper pigmentation  is one of the most frequent cosmetic complaints in the country and even more so in areas like ours where there are so many sunny days. Sun exposure is the light switch for this problem. Hyperpigmentation in its simplest explanation is an over-production of the natural pigment in your skin. The starting factor could be a genetic predisposition, sun exposure, or as a result of hormone changes or the use of birth control pills - as in the case of melasma or a "pregnancy mask" during and after pregnancy.

The major cause of splotchy skin and brown markings on the face, chest, arms and hands is sun exposure. No matter what terminology used - brown spots, melasma, age spots, "liver spots", sun spots, blotchy skin or any other name - hyper pigmentation is a melanin response to some kind of trigger. A major component in preventing and controlling uneven pigmentation is the use of effective sunscreens. This becomes especially important during and following the various medical treatments used to reduce discoloration in the first place.

A wide variety of treatments are available for brown spots and hyper pigmentation. The cause of your hyper pigmentation will determine the most effective method to help lighten, blend and control the problem. Dr. Sikorski will ask questions about your background, work environment, sun habits and medication use to carefully determine the source of the problem and decide which treatment is most suitable and most effective for your particular skin color, skin type and skin problem. Lifestyle plays into the treatments. If you can't or won't stay out the sun, some procedures will just compound the problems.

Some of the more useful measures in treating brown spots and pigmentation:

• Cosmelan - An intensive topical treatment program that inhibits melanin production and lightens your skin with non-hydroquinone ingredients
• MIXTO Laser - A fast-healing laser treatment that has FDA approval for Melasma and Chloasma and Sun-induced hyperpigmentation
• Photofacial IPL – Intense light exposure to reduce red and brown skin discolorations
• Chemical Peels - Over-all skin regeneration by chemically causing a peeling of your damaged skin
• Sciton Skin Resurfacing Laser for intense pigmentation, though for certain skin types ablative lasers should be avoided
• Hydroquinone based lightening prescription creams
• Retinoic acid topical gels or creams
  

What’s the role of melanin in hyper pigmentation?

To have an understanding of what hyper-pigmentation is, it's important to understand the role of melanin. Your skin color, whether light or dark, comes from melanin. Melanin is the pigment that your body produces. Pigment determines the color of your skin, hair and eyes. The more melanin produced, the more color and the more "color-potential" you have in your skin.

About five percent of the cells in your epidermis are special cells called melanocytes. When exposed to ultraviolet B light (short wave ultraviolet), melanocytes produce melanin--the pigment which is ultimately responsible for a tan or a tan gone awry in the case of hype pigmentation. The newly formed melanin moves up through the epidermis and is absorbed by other skin cells. When exposed to ultraviolet A light (longer wave), the melanin oxidizes or darkens. This darkening is your skin's way of protecting itself against too much UV light.

Everyone has the nearly the same number of melanocytes in their body - about five million. But your heredity dictates how much melanin your body's melanocytes naturally will produce. For example, the skin of African-Americans contains enough melanin to create a black or brown skin color, while the skin of Caucasians has less melanin and is pale.

To a great degree, your ancestry determines your susceptibility to having brown spots or brown patches on your skin. Most people with Scandinavian backgrounds have little incidence of pigmentation problems. If, however, you are of Latin America, Middle Eastern or Asian descent, you will have far more melanin cells and the resulting likelihood of hyper pigmentation is significantly higher.

top

Major Causes of Hyper Pigmentation and Brown Spots

I. Hyper-pigmentation from Sun Exposure:  One of the primary functions of melanin production in your skin is to protect you from UV rays from the sun. A "tan" is a prime example of your body's melanin response to the sun.

When the skin is repeatedly exposed to the sun, you experience sun damage in a variety of ways and one of those is brown spots and hyper-pigmentation. Once the cycle of pigment over-production has started, it's difficult to stop it and usually medical intervention is required.

II. Hyper-pigmentation (Melasma or Chloasma) from Hormones:  The second most frequent cause of hyper-pigmentation is hormone shift. Birth control pills, pregnancy or the various stages of menopause create changes in hormone levels that can trigger melanin cells to go into over-drive. This can happen even if you are not a sun worshipper. However, if you have hormone-related pigmentation problems, you still need to be careful since sun exposure will always make it worse.

III. Hyper-pigmentation from injury (termed Post-Inflammatory Hyper pigmentation or PIH): The third most common cause of pigmentation is a direct result of some type of injury to the skin.

Acne-related Post inflammatory hyperpigmentation Photo source: Valerie D. Callender, M.D.

Common pigmentation-causing injuries include Acne or acne cysts Abrasions or cuts Insect bites or itchy rashes Over-exposure to heat Hair waxing Improperly performed laser treatments

How does injury create hyperpigmentation?

Your body's response to injury is inflammation. Often you don't even see the inflammation since much of it occurs beneath the epidermis. This inflammation triggers melanin production and the result is a brown patch,color lines or stripes.

Improper use and application of heat generating devices is a risk many people take when they frequent unsupervised medspas or medical offices that really don't have training in skin and skin response. Lasers are medical devices and belong in a qualified medical office. In many cases throughout the country inadequately trained technicians in spas and stand alone unsupervised laser “clinics” have caused scarring, color changes and irreparable damage to their clients' skin. Post inflammatory hyperpigmentation (PIH) is only one of the reasons you should always have medical treatments such as hair laser removal, photofacial, or any type of laser or light treatment performed in a dermatology office under the properly trained guidance of a board certified dermatologist.

Preventing and Minimizing the incidence of hyperpigmentation

Sun exposure is the #1 cause of facial and body brown spots, age spots, freckles, moles and pre-cancerous actinic keratosis. The only way to proactively prevent the majority of environmentally-caused hyperpigmentation is to protect your skin from the sun.

Sunscreen, sunblock, hats and sun-protective clothing are your first line guard against not only unsightly brown patches but also sun damage that could lead to skin cancer. Hormones, injury and pigmentation from allergic reactions or skin disease such as acne are mostly beyond your control. But you are in control of how well your skin is protected from the sun.