Pigmentation & Brown Spots
Hyper pigmentation is one of the most frequent cosmetic complaints in the country and even more so in areas like Orange County 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. During your consultation with Dr. Sikorski, she 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?
Understanding the role of melanin allows us to understand how hyper-pigmentation works. The color of your skin, whether light or dark, is produced by melanin. Melanin is the a pigment produced by your body that determines the color of your skin, eyes and hair. The more melanin your body produces the more color and “color-potential” you have in your skin.
Specialized cells called melanocytes make up about five percent of the cells in your epidermis. When melanocytes are exposed to ultraviolet B light (short wave ultraviolet), they produce melanin which is the pigment responsible of a tan or melanin over production in the case of hype-pigmentation. The newly formed melanin moves up through the epidermis and is absorbed by other skin cells. When the skin is exposed to ultraviolet A light (longer wave), the melanin absorbed by skin cells oxidizes or darkens. The skin darkening is the skin’s natural 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 how susceptible you are to having brown spots or brown patches on your skin. Most OC patients with Scandinavian backgrounds have little incidence of pigmentation problems. If, however, you are of Latin America, Middle Eastern or Asian descent, you will have more melanin cells and the likelihood of hyper pigmentation is significantly higher.